Hello doctor, My 85-year-old father had mild pain in his thighs and shoulder girdle for two months which intensified in the past two weeks to a point that he could not get up from his bed. He was started on oral steroids 30 mg once daily for the past three days and has shown a 40% response but cannot stand. Blood tests were done yesterday showing normal serum electrolytes, bilirubin, TSH, and CBC with some iron deficiency. Raised values are CPK - 272, BUN - 50, SGOT - 50, SGPT - 100, and leucocytes - 29000. His Hb is 9 and eosinophilia 42 since before. Kindly suggest the diagnosis.
Hello. Well as per your history, it does look.like a diagnosis of polymyalgia rheumatica. I would like to ask you a few more queries related to his illness. When is the pattern of pain more mornings or evenings? Does he experience morning stiffness as well? Any history of weight loss or appetite loss? Any history of jaw pain or headache or fever? Do you have his reports of ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), rheumatoid factor available? As they are the most important to monitor and diagnose. Did they do any scans of the chest and abdomen? As of now the reports do not seem very great with high leukocyte count and low Hb. Diagnosis of polymyalgia rheumatica looks certain but we should rule out any underlying trigger.