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Sunday, 24 November 2013

Polymalagia Arthritis - The Causes and Rick factors

Polymalagia Arthritis Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which cause pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdleas a result of the presence of a synovitis in proximal joints and periarticular structures, causing musculoskeletal symptoms in PMR.
B. Causes and Rick factors
B1. Causes
The cause of PMR is not well understood, but researchers believe it is a result of the abnormal inflammatory activity of inflammatory cells and proteins of the immune system due to the presence of a synovitis in proximal joints and periarticular structures.
1. Genetic factors
In the study to evaluate HLA-DRB1 associations in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in the Spanish population, showed that he HLA-DRB1 alleles associated with susceptibility for developing PMR and GCA are different. Whether PMR with low ESR represents a different clinical subset of the disease should be clarified in a larger sample of patients. HLA-DRB1 genes might predict the presence of relapses in PMR, but they do not seem to be indicators of severe disease in GCA patients(7).
   
2. Environmental contagious factors
In the review personal and published observations of giant cell (temporal) arteritis (GCA) or polymyal-gia rheumatica (PMR) with familial or conjugal aggregation and emphasise on epidemiological, clinical and genetic features of such cases, showed that familial aggregation of GCA and PMR accumulated data pointing to a genetic predisposition. However, environmental contagious factors could have trigger synchronous disease onset in up to one-fourth of the cases(8).
3. Giant cell arteritisGiant cell arteritis (GCA) is an inflammatory vasculopathy that involves large- and medium-sized arteries and can cause vision loss, stroke and aneurysms. GCA occurs in people aged >50 years and is more common in women. A higher incidence of the disease is observed in populations from Northern European countries. Polymyalgia rheumatica (PMR) is a periarticular inflammatory process manifesting as pain and stiffness in the neck, shoulders and pelvic girdle. PMR shares the same pattern of age and sex distribution as GCA. The pathophysiology of PMR and GCA is not completely understood, but the two conditions may be related and often occur concurrently(9)
4. Etc.
B.2. Risk factors
1. Aging
If you are over 50 years of age, you are at increased risk of Polymalagia Arthritis (PMR). Polymyalgia rheumatica is a rheumatic disease which mainly affects the elderly, and is seldom diagnosed in patients <50 years of age. the prevalence polymyalgia rheumatica is approximately 16.8 to 53.7 per 100,000 of the population >50 years of age(10).
2. Diet
In the study to investigate the association of red meat and other specific dietary components in predicting the development of inflammatory polyarthritis, DR. Pattison DJ, and the research team at the University of Manchester, indicated that high level of red meat consumption may represent a novel risk factor for inflammatory arthritis or may act as a marker for a group of persons with an increased risk from other lifestyle causes(11).
3. Smoking
In the study to examined the influence of smoking on disease outcome at 3 years among patients newly presenting with inflammatory polyarthritis (IP), indicated that Despite smokers being more likely to develop nodules and to be RF positive, current smokers did not have higher levels of radiologic damage, and had fewer swollen joints. We hypothesize that this could be due to either the effect of cigarette smoking on the inflammatory response or other factors (e.g., reduced physical activity in smokers) which may limit joint inflammation and damage(12).
4. Gender
If you are women, you are at increased risk to develop Polymalagia Arthritis
5. Race
Rheumatic diseases are common in China. In the study to clarify prevalence rates of common rheumatic diseases in China, using the World Health Organization-International League of Associations for Rheumatology COPCORD (Community Oriented Program for Control of Rheumatic Diseases) protocol and those that did not employ this protocol but were published in recognized journals were identified and analyzed. showed that the prevalence of rheumatic complaints varied with the locality surveyed. The prevalence of OA is comparable with that in Western countries but varies in terms of joint involvement. The prevalence of ankylosing spondylitis is similar to that in Caucasians. Except in Taiwan, the prevalence of RA in China is lower than that in developed countries. The prevalence of hyperuricemia and gout increased after the 1980s, but it remains lower than that in developed countries(13).
6. Etc.

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Sources
(7) http://www.ncbi.nlm.nih.gov/pubmed/15305244
(8) http://www.ncbi.nlm.nih.gov/pubmed/19646354
(9) http://www.ncbi.nlm.nih.gov/pubmed/21812500
(10) http://www.ncbi.nlm.nih.gov/pubmed/19562970
(11) http://www.ncbi.nlm.nih.gov/pubmed/15593211
(12) http://www.ncbi.nlm.nih.gov/pubmed/11229462 
(13) http://www.ncbi.nlm.nih.gov/pubmed/18237382