My symptoms started about 6months ago-general bilateral aching, sweats and high temperatures. I am very stiff when getting up in the morning and after any period of rest. My biggest problem has been daily high temps-about 39.4 which are followed by drenching sweats. No redness or joint swelling but CRP is 75. I have my first rheumatology appt next week (referred by oncologist who excluded anything worse). Am wondering if you think my symptoms sound more like pmr than RA? Any advice for my first appt would be welcome too.
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Granv1lle
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Yes, I'd say PR is probably more likely than RA - but you can never tell as LORA (late onset RA) can present looking identical to RA in the early stages. However - with the drenching sweats, they should also consider GCA or LVV (large vessel vasculitis).
PMR is not really possible to diagnose as such. Basically it is diagnosed when it is found that it could not be anything else! Sometimes it is fairly obvious by the symptoms but doctors can still be wrong. The best check is to take steroids for a week and see if you feel better.
This is my intro post on PMR/GCA for new patients, night be worth having a look at and see what strikes a cord with you... and might give you some idea of what to ask. But a trial of steroids should most certainly be on the cards...
Thank you, DorsetLady. You have provided lots of really useful info
One would need to know the results of a ton more tests as to have any clue as to your diagnosis. Recurrent high temperatures are not really a feature of PMR. I would have thought that a trial of steroids was not on the cards just at the moment. Something infective or inflammatory is likely brewing though. Oncologist??
Thanks for your reply, Sillydogsmum. I have had a very comprehensive raft of blood tests-all normal apart from slight anaemia and very high inflammatory markers. The GP then wanted to rule out lymphoma as some enlarged glands showed up on CT scans so I got initially referred to oncology. A bone marrow was clear so I’ve been discharged for oncology and referred to rheumatology. It is the very high temperatures that baffle me too but the medics I’ve seen so far don’t think I have an acute infection going on so likely inflammatory.
Adult onset Stills disease which was diagnosed in 1979 started with afternoon fevers, rashes, headaches, sore throat and joint pain. All these years on and I regularly experience this effect between 3 and 6 pm - I know, odd isn’t it. Even during the menopause years the two sets of fever/flushes were distinguishable from each other. Sadly I can offer no explanation or advice, I simply have to lie down until it stops.
Just to update-the rheumatologist didn’t think I had PMR because of my temperature. However, after GCA scan, lymph node biopsy and every blood test known to man they haven’t come up with a diagnosis. The biopsy showed reactive inflammation and my CRP is high at 75. Lots of bilateral aches and pains, fever and night sweats. Headaches are new and have been fairly persistent for last 3 weeks. I’ve been referred now to the infectious diseases team but if they can’t diagnose me then they are going to start me on a trial of steroids. I’m pretty down about it all as I thought PMR was a diagnosis of exclusion rather than a positive finding and all I have is a temperature on top of many of the usual symptoms.
Thanks for update .. and despite results I’m still not totally convinced it isn’t GCA … and yes a course of steroids might be very useful! As you state, there are a lot of other GCA type symptoms present.
Do keep us informed please ,and obviously if any unusual sight issues then you need urgent advice, and I’m sure you are feeling pretty down about things..
Thanks both. I think you are right. There are always exceptions and there is already a case reported of someone with pmr and high fever. Still a lot of research needed into this
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