A Polymyalgia Rheumatica-Mimicking Case with Young Adult Onset

The diagnosis of polymyalgia rheumatica (PMR) is made primarily on clinical features and laboratory evidence of inflammation. Among the criteria for diagnosing PMR, disease onset at an age of 50 years or over is one of the major premises. The present case with 35-year-old onset showed clinical features of symmetric proximal myalgias (shoulder and pelvic girdle) with pronounced stiffness for more than 3 weeks, morning stiffness lasting more than 45 minutes combined with laboratory abnormalities (elevated CRP and ESR), and a dramatic improvement with steroid treatment at a low dosage (20mg/day), which is quite compatible with PMR except for the age of onset of the disease. This case shows that PMR-mimicking conditions can occur in patients even under 50 years of age.