vasculitis

[HamishPMR]

Is vasculitis often associated with PMR?

[winfong]

Depends upon what you mean by "vasculitis." Technically, PMR is a form of vasculitis, as are GCA, LVV, lupus, Sjogrens & many others.

[AtopicGuy in reply to winfong]

Not quite. Only a subset of lupus, Sjogren's and PMR cases involve detectable vasculitis. See my summary below.

[DorsetLady PMRGCAuk volunteer]

Vasculitis is the name that covers many illnesses/conditions that cause problems with/in blood vessels…

NHS -

nhs.uk/conditions/vasculiti....

[PMRpro Ambassador]

GCA is a vasculitis, so is LVV, PMR is associated with both and is considered part of a spectrum of disease but they can't SEE any inflamed blood vessels as they are probably too small to identify

[AtopicGuy]

This link gives the most accurate, succinct and easy-to-read summary I have yet found for vasculitis. It's from the John Hopkins University Medical School in the USA, so it's a good, up-to-date source:

hopkinsvasculitis.org/types...

As you can see, there are "approximately 20 different disorders that are classified as 'vasculitis'". PMR is not one of them, but GCA is. Only a subset of Lupus cases are.

The suspicion that inflammation of blood vessels is the underlying cause of at least some cases of PMR is because GCA patients and PMR patients are at significantly higher risk of developing the other condition as well. There is surprisingly little good evidence that vasculitis is a major cause of more than a minority of PMR cases. High CRP and/or ESR levels, are usually present in PMR, meaning inflammation is somewhere in the patient's body. But attempts to find the location of the inflammation using FDG PET/CT rarely point towards blood vessels, if anywhere, unless GCA is also suspected. For example, see this 2020 meta-analysis, which pulls together the evidence from several previous studies:

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

Note: Contrary to what many doctors claim, FDG PET/CT scans are not good at spotting low-level inflammation, which may be spread over wide areas. Nor can they reveal hardening or narrowing of blood vessels unless severe, active inflammation is still ongoing.

[HamishPMR in reply to AtopicGuy]

Thank you very much for going to so much trouble. Hamish.