Polymyalgia Rheumatica Complicated by Nephrotic Syndrome in a Nonagenarian: A Case Report

This case report describes a 91-year-old bedridden man with a complex medical history who presented with fever and low oxygen saturation, suspected to be aspiration pneumonia. Further investigation revealed nephrotic syndrome, microscopic hematuria, and joint pain. The diagnosis of polymyalgia rheum...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-08, Vol.16 (8), p.e66592
Main Authors: Nakagawa, Ayato, Yamamoto, Natsumi, Sano, Chiaki, Ohta, Ryuichi
Format: Article
Language:English
Subjects:
Abdomen
Amyloidosis
Anemia
Antibodies
Antigens
Biopsy
Case reports
Delirium
Family/General Practice
Geriatrics
Glucose
Hematuria
HIV
Human immunodeficiency virus
Immunoglobulins
Inflammation
Kidney diseases
Oxygen saturation
Patients
Physicians
Pleural effusion
Pneumonia
Proteins
Remission (Medicine)
Rheumatology
Steroids
Urine
Viral infections
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Summary:This case report describes a 91-year-old bedridden man with a complex medical history who presented with fever and low oxygen saturation, suspected to be aspiration pneumonia. Further investigation revealed nephrotic syndrome, microscopic hematuria, and joint pain. The diagnosis of polymyalgia rheumatica (PMR) was considered due to the presence of characteristic symptoms and elevated inflammatory markers despite the inability to perform a kidney biopsy. The patient was treated with low-dose prednisolone (PSL), leading to significant improvement in joint pain, renal function, and overall condition. This case highlights the importance of considering PMR in elderly patients with unexplained nephrotic syndrome and systemic inflammation. Early diagnosis and corticosteroid treatment can improve clinical outcomes and enhance activities of daily living. This report underscores the need for awareness of PMR as a potential cause of nephrotic syndrome in the elderly and the effectiveness of PSL in managing such cases.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.66592