Viruses and polymyalgia rheumatica
Polymyalgia rheumatica and giant cell artiritis are closely associated disorders of unknown cause. There is some assumption about the connection viruses infection and polymyalgia rheumatica, including the adenovirus, which causes respiratory infections; the human parvovirus B19, an infection that affects children; and the human parainfluenza virus. There is no laboratory investigations on this, but treatment then could be immune gamma globulin injections. Some polymyalgia rheumatica treatment get by long-term antibiotics, such as doxycycline, in combining to the prednisone.
For example, at 1975 P.A. Bacon establishes an increased incidence of hepatitis B virus antibody. This may be a significant discovery, as some reports during the last few years have demonstrated a bond between hepatitis B virus infection and later occurrence of vasculitis (polyarteritis nodosa, essential cryoglobulinaemia).
Experimental studies on this question were carried out some years later by Hanne Elling.
The standard serological events in the course of hepatitis B virus infection are characterized by the happening of several antibodies and antigens, of which the e/anti e system are indicators of chronicity.
From the delicate examination used in the various investigations it can be concluded that signs of active hepatitis B virus replication such as are seen in some cases of polyarteritis nodosa and other types of vasculitis is not a characteristic of polymyalgia rheumatica or giant cell artiritis.
Nor does the biology experiment back up the concept of any relationship between prior hepatitis B virus infection and next occurrence of polymyalgia rheumatica in the more than half of patients.
Experimental studies reveal a frequency measure twice as high in the untreated group as in the steriod treated, which may suggest, as proposed by P.A. Bacon, that prednisone decreases the antibody titre effectively.
Lab investigation do not refute the facts for hepatitis B virus connection in some cases of polymyalgia rheumatica, but supply facts that the advocacy of this virus as the larger cause of polymyalgia rheumatica is greatly overstated. Polymyalgia rheumatica as a syndrome may be a last usual pathway for a diversity of antigen-antibody complex interactions.
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