Patients with PMR generally will have resolution of symptoms with proper treatment and a self-limited course, although some patients subsequently develop signs and symptoms of GCA. Feared complications of GCA include stroke, loss of vision, and extremity ischemia. Aneurysms occur at a frequency of about 15 times the expected rate and are associated with increased risk of premature death (26).
Glucocorticosteroid treatment-related adverse events occur commonly among these elderly patients, and at least 65% of patients may have at least one adverse event (3). Patients are at a risk for diabetes mellitus and osteoporosis with osteoporotic fractures, which occur in this patient group at a rate two to five times higher than in age-matched controls. Complications are more frequent in patients over the age of 75 and patients receiving higher doses of steroids (3). All patients should receive calcium and vitamin D supplementation and appropriate treatment for osteoporosis including bisphosphonates.
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