Abstract
This paper aims to evaluate adrenal gland hormone levels in patients with polymyalgia rheumatica (PMR) during glucocorticoid (GC) therapy. A lower than expected basal production of cortisol was found in active and glucocorticoid-untreated PMR patients, particularly females. The abrupt onset of PMR with clinical features similar to those of the steroid-withdrawal syndrome or adrenal insufficiency, as well as the clinical response to GC therapy in elderly people already age-disposed to an inadequate adrenal and anti-inflammatory response, might represent the most significant pathophysiological basis of the disease.
MeSH terms
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Adrenal Cortex / drug effects
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Adrenal Cortex / metabolism*
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Adrenal Hyperplasia, Congenital
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Adrenocorticotropic Hormone / blood
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Adrenocorticotropic Hormone / metabolism
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Aged
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Aging / immunology
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Aging / physiology
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Androstenedione / blood*
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Androstenedione / metabolism
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Area Under Curve
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Biomarkers
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Blood Sedimentation
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C-Reactive Protein / analysis
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Corticotropin-Releasing Hormone
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Dehydroepiandrosterone / blood*
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Dehydroepiandrosterone / metabolism
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Female
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Humans
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Hydrocortisone / blood*
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Hydrocortisone / deficiency
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Hydrocortisone / metabolism
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Hypothalamo-Hypophyseal System / physiopathology
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Inflammation
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Interleukin-6 / blood
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Male
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Neuroimmunomodulation
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Pituitary-Adrenal System / physiopathology
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Polymyalgia Rheumatica / blood
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Polymyalgia Rheumatica / drug therapy*
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Polymyalgia Rheumatica / immunology
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Polymyalgia Rheumatica / physiopathology
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Secretory Rate / drug effects
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Testis / drug effects
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Testis / metabolism*
Substances
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Biomarkers
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Interleukin-6
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Androstenedione
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Dehydroepiandrosterone
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Adrenocorticotropic Hormone
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C-Reactive Protein
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Corticotropin-Releasing Hormone
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Hydrocortisone