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  • Title: Polymyalgia rheumatica in a renal transplant patient.
    Author: Banerjee S, Brosnahan G.
    Journal: J Ark Med Soc; 2008 Nov; 105(5):115-7. PubMed ID: 19006913.
    Abstract:
    A 56-year-old African American woman who was on triple immunosuppressive therapy (which includes tacrolimus, mycophenolate mofetil, and prednisone) for a renal transplant that she had received 10 years ago presented with malaise, low-grade fevers and severe bilateral pain in her shoulder, neck and thigh muscles. There was serological evidence of an acute inflammatory syndrome, including a very high erythrocyte sedimentation rate (ESR) and high interleukin-6 and C-reactive protein levels. An extensive workup for infection and malignancy was negative, and a muscle biopsy was normal. Under a working diagnosis of polymyalgia rheumatica (PMR) her prednisone dose was increased, leading to a complete remission.; her symptoms resolved and the ESR normalized. The occurrence of PMR in an immunosuppressed patient is unusual, but should be considered in the differential diagnosis in the appropriate clinical setting.
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