The Early History of Polymyalgia Rheumatica and GCA - PMRGCAuk

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The Early History of Polymyalgia Rheumatica and GCA

123-go profile image
35 Replies

Rather a long read but may be of interest. There may well be other similar articles but I was surprised to learn here that these diseases appear to have been discovered/recognised as recently as mid-20th mayoclinicproceedings.org/a...

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Bluey-1 profile image
Bluey-1

Can you add a link to the article please?

123-go profile image
123-go in reply toBluey-1

Have edited to include link.

DorsetLady profile image
DorsetLadyPMRGCAuk volunteer

This from link below - seems to indicate GCA earlier than that -

Horton named the disease temporal arteritis in a description of two cases in 1932 (earning the eponym “Horton’s disease”) and later went on to conclude that it was an autoimmune disease, after performing temporal artery injections into patients with quiescent disease, producing relapses [2]. However, the disease had been reported first by Hutchinson in 1890, who described what he called “thrombotic arteritis of the aged,” in an 80-year-old man who presented with swollen red streaks on his temple that became thrombosed “cords” [3]. One may wonder if GCA existed prior to the 1800s since no prior descriptions have been found in the medical literature, but stigmata of the disease have been noticed in several paintings from as early as the 1400s [4].

ncbi.nlm.nih.gov/pmc/articl.../

piglette profile image
piglette

It was Paul R. Ehrlich (in 1901) with his staunch rejection that autoimmunity was possible, with his famous “horror autotoxicus” which denied the existence of auto-immune diseases. It seems that largely thanks to Ehrlich, the existence of autoimmune disorders was still treated as an open question well into the 1950s.

123-go profile image
123-go in reply topiglette

Hadn’t heard of him but a quick search shows that he held controversial views on certain subjects.

piglette profile image
piglette in reply to123-go

He got the Nobel prize for immunology. He probably was not the type of person who would have been much fun down the local pub though.

123-go profile image
123-go in reply topiglette

🤭

PMRpro profile image
PMRproAmbassador in reply to123-go

See my reply to piglette - Paul Ehrlich or Paul R Ehrlich???

piglette profile image
piglette in reply toPMRpro

Forget the R, I forgot about the other Paul Ehrlich!!

PMRpro profile image
PMRproAmbassador in reply topiglette

Far too confusing having almost the same names!!!

123-go profile image
123-go in reply toPMRpro

I once had two children in my class with exactly the same name.😵‍💫

piglette profile image
piglette in reply to123-go

Really annoying!!

PMRpro profile image
PMRproAmbassador in reply topiglette

Um - not Paul R Erlich, he's an American population biologist, more current (b1932 and still alive) and controversial since some of his predictions didn't meet their deadlines - however, they are starting to look more likely by the year.

The immunity guy who predicted the concept but rejected "horror autotoxicus" as impossible was a German physician, Paul Ehrlich (1854-1915) immunology.utoronto.ca/auto...

I think this is a good read:

pioneerworks.org/broadcast/...

I wonder which has done more damage: Ehrlich rejecting autoimmunity or Ancel Keys and his low fat thesis. Both were fixated on their own belief and rode roughshod over any scientists who disagreed.

piglette profile image
piglette in reply toPMRpro

I wonder if the two Pauls were related?

PMRpro profile image
PMRproAmbassador in reply topiglette

Wiki says not

"Ehrlich was born in Philadelphia, Pennsylvania, the son of William Ehrlich and Ruth Rosenberg. His father was a shirt salesman (unrelated to the German scientist Paul Ehrlich), his mother a Greek and Latin scholar[14] and public school teacher.[6] Ehrlich's mother's Reform-Jewish German ancestors arrived in the United States in the 1840s, and his paternal grandparents emigrated there later from the Galician and Transylvanian part of the Austrian Empire.["

Though maybe if you go far enough back in the central European Jewish community there might be a link!

fmkkm profile image
fmkkm in reply toPMRpro

Paul R., his book, The Population Bomb, was very popular when I was in college.

random901 profile image
random901

Really interesting and surprisingly accessible even to a non-medic like me. Things have come a long way, thank goodness!

123-go profile image
123-go in reply torandom901

Haven’t they just? There will undoubtedly be further advances that we may very well never get to hear of ☹️.

Crwbin1 profile image
Crwbin1

very good and interesting article.

fmkkm profile image
fmkkm

Very interesting article. What a frightening outlook and outcome for GCA sufferers before prednisone was found helpful in the late 40’s. It makes me really thankful for this simple but very effective treatment!!

dmart7 profile image
dmart7

Very interesting article. I'm a long-standing genealogist (for fun rather than remuneration) so have seen the details of illness or death of a large number of our ancestors. Like the authors of the paper, I can't recall anything which might be a Victorian (or earlier) case of PMR or GCA. They often used vague-sounding descriptions for medical conditions such as"general decay" or "general paralysis of the insane" (in the latter case the terminal consequences of syphilis). The fascinating question about PMR's prevalence more than 100 years ago remains unanswered. Not surprising perhaps, given that we generally live much longer now, and PMR is usually found in those older than 50, 60 or 70.

123-go profile image
123-go in reply todmart7

I believe that it’s entirely possible that PMR and GCA were in existence 100 years ago. We have to remember that scanners, ultrasound equipment etc were not in existence in those times but what a relevation for medics when they came along! We have so much to be grateful for including dedicated continuing research.

You have an exciting pastime/hobby.

PMRpro profile image
PMRproAmbassador in reply todmart7

The first paper about PMR was written in 1888 by a Scottish doctor, William Bruce - and he called it senile rheumatic gout. The entire cohort of 6 patients was male - how typical!! To some extent it isn't surprising very little was written about it - there was no cure available until after WW2. It was probably perceived as an inevitable part of aging if you lived long enough - a very high proportion of 80-year olds have had or have PMR.

123-go profile image
123-go in reply toPMRpro

That accounts for low SATs marks 🤭😂😂.

Best laugh I’ve had for days: thank you.x

PMRpro profile image
PMRproAmbassador in reply to123-go

Duly edited!!! Fingers haven't woken up yet ...

123-go profile image
123-go in reply toPMRpro

Mine don’t wake up till bedtime 😏.

AtopicGuy profile image
AtopicGuy in reply todmart7

My great-aunt lived with us until she died in the 1970s. As a child, I distinctly remember her coming home from the doctors' saying, "rheumatism is what they say you've got when they don't know what you've got!" She was a smoker (not around the kids), a practice that surged among women after WW1. This long-term study of female nurses found a moderately-strong link between PMR and smoking: for example, a pack of 20 per day for 50 years increases the risk of PMR by 50%.

acrabstracts.org/abstract/c...

S4ndy profile image
S4ndy

Very interesting article. I have always suspected that what my maternal grandmother called "the Rheumatica" or "thrombosis arthritis" was PMR. I recall her symptoms being very similar to mine. She was born in 1900 and lived until 1978. I don't recall what medication she was taking but guessing not much that would have helped her. She was definitely addicted to Kaolin and Morphine medicine though, getting through a couple of bottles a week. I used to have to go get it from the chemist who mixed it up in the back of his shop! She actually died of heart failure following a cardiac arrest.

My maternal aunt also suffered the same symptoms as my Gran. Being younger I think they initially blamed "the change" as they referred to it. However, I recall that my aunt also had "rheumatic" problems as she would describe it. She too had similar symptoms to me I recall. I seem to remember her taking little white pills every morning before she could manage to get out of bed.

It's interesting how things in medicine are named/described. My mother died young of cancer. Makes me wonder if she might have had PMR too if she had lived longer.

Think there's a possibility that there's hereditary genetics at play within my family.

My maternal uncle also had some type of vascular problem. Being a man he never spoke about it to me. He actually died of an aortic aneurysm. He also had had some cardiac issues which made him take early retirement. He was a master carpenter/ shipbuilder and you can still admire one of his creations the replica if the Golden Hind (made at an Appledore Shipyard in Devon) which is moored on the South Bank. I do wonder if he might have had undiagnosed GCA.

Guess we will never know but it's interesting in hindsight

PMRpro profile image
PMRproAmbassador in reply toS4ndy

My grandfather and a maternal great aunt both had symptoms that were almost certainly untreated PMR and had them for years.

Katietee profile image
Katietee

Many thanks for your extremely interesting post. Much appreciated!

DAW28 profile image
DAW28

Thank you for posting this very interesting article.

Plains profile image
Plains

very interesting read! Thank you

tangocharlie profile image
tangocharlie

Of course PMR didn't exist before, unless it happened to men, as women didn't really exist, and if they ever complained they wer told everything was all in their heads. And then probably because men tend to get over it more quickly and smoothly the myths started about it generally lasting 6 months to 2 years😜

123-go profile image
123-go in reply totangocharlie

Brilliant!

SheffieldJane profile image
SheffieldJane

Interesting, thanks for sharing.

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