08 May 2019 : Case report
Myalgia with Elevated Inflammatory Markers in an Obese Young Female: Fibromyalgia or Polymyalgia Rheumatica?
Mistake in diagnosis
Rabia Cheema12ABCDEF, April Chang-Miller3ACDE, Fawad Aslam3ABCDEF*DOI: 10.12659/AJCR.915564
Am J Case Rep 2019; 20:659-663
Abstract
BACKGROUND: Fibromyalgia (FM) is a common disorder of diffuse musculoskeletal pain. It is distinctly different from polymyalgia rheumatica (PMR), a disease seen in people over the age of 50 years. Hallmark features of PMR are the presence of elevated erythrocytes sedimentation rate (ESR) and/or C-reactive protein (CRP). These markers are normal in FM. Obesity in itself can be associated with elevated CRP and ESR, and when obese patients present with myalgia and elevated inflammatory markers, diagnostic confusion can ensue.
CASE REPORT: We describe a case of 38-year-old female with diffuse musculoskeletal pain and elevated ESR and CRP who was initially misdiagnosed with PMR and responded partially to steroids. She developed severe adverse effects from chronic steroid use. She was ultimately diagnosed with FM.
CONCLUSIONS: We highlight features to help clinicians avoid the pitfall of diagnosing PMR in young obese patients with FM and elevated inflammatory markers. In this case report, we discuss the features of FM, PMR, PMR-like symptoms presentation, and the association of obesity with elevated inflammatory markers.
Keywords: C-Reactive Protein, Fibromyalgia, Obesity, Polymyalgia Rheumatica, Blood Sedimentation, Diagnostic Errors, Myalgia
In Press
Case report
A Rare Complication of Cannabinoid Hyperemesis SyndromeAm J Case Rep In Press; DOI: 10.12659/AJCR.945106
Case report
Dynamic Ultrasound Assessment of Celiac Artery Flow Velocity in Median Arcuate Ligament Syndrome DiagnosisAm J Case Rep In Press; DOI: 10.12659/AJCR.945253
Case report
Recurrent Heterotopic Pregnancy Following Frozen-Thawed Embryo Transfer: A Case Study and Comprehensive Lit...Am J Case Rep In Press; DOI: 10.12659/AJCR.945053
Case report
Iron-Related Pseudomelanosis Duodeni in a Patient with Gastrointestinal Bleeding: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.945238
Most Viewed Current Articles
21 Jun 2024 : Case report 57,486
Intracranial Parasitic Fetus in a Living Infant: A Case Study with Surgical Intervention and Prognosis Anal...DOI :10.12659/AJCR.944371
Am J Case Rep 2024; 25:e944371
07 Mar 2024 : Case report 42,466
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report 32,431
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
23 Feb 2022 : Case report 19,902
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250