Polymyalgia rheumatica following paraspinal muscle inflammation and sacroiliitis

Regarding etiology, the cause of PMR is still unknown. There are several reports about a genetic association involving genes for intercellular adhesion molecule 1, interleukin 1 receptor antagonist, and interleukin 6 [1]. There is no direct evidence for an infectious cause of PMR, although the incidence of PMR was reported to coincide with epidemics of Mycoplasma pneumoniae, parvovirus B19, and Chlamydia pneumoniae infections [1]. There is a report of three patients with PMR who weresuccessfully treated with the antibiotic clarithromycin. However, the authors considered that the effectiveness of clarithromycin in PMR was due to its anti-inflammatory effects, not its antibacterial activity [5]. There are reports that patients with PMR may have disturbances in the hypothalamic-pituitary-gonadal axis with some adrenal insufficiency, but this remains to be confirmed [1]. KCI Citation Count: 0