Atypical Systemic Lupus Erythematosus Presenting as Polymyalgia Rheumatica in an Elderly Native American Male

Stephen Bastible, Megan Tramel, Caleb Alexander, Prashant Kaushik

Research output: Contribution to journalArticlepeer-review

Abstract

A 78-year-old Native American male presented to the clinic for evaluation and treatment of polymyalgia rheumatica (PMR) that initially began with extreme shoulder and hip pain, later involving the neck and ankles. At the time of presentation, he had been treated with oral prednisone for a year; 5 mg in the morning and 2.5 mg in the evening. Two attempted trials without prednisone during that year resulted in a rebound of articular symptoms. Upon completing laboratory studies and evaluating this patient in the Rheumatology clinic, his presentation actually favored a diagnosis of late-onset, atypical systemic lupus erythematosus (SLE) due to his peripheral joint involvement, positive ANA (titer of 1:160 with a speckled pattern), significantly positive double stranded (ds) DNA, beta-2 glycoprotein IgG, and cardiolipin IgG antibodies. To our knowledge, this is the first of such cases to be documented.
Original languageAmerican English
Number of pages3
JournalArchives of Rheumatology & Arthritis Research
StatePublished - 18 Mar 2024

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