POLYMYALGIA-RHEUMATICA AND THYROID PAPILLARY CARCINOMA

This is a case report of a 64-year-old woman with polymyalgia rheumatica (PMR) and thyroid papillary carcinoma. Peripheral blood lymphocyte response to pokeweed mitogen, concanavalin A and phytohemagglutinin was increased compared to controls during aggravation of PMR. These responses were normalized to control values after low-dose corticosteroid therapy (prednisolone 10 mg; 7 days and 7.5 mg; 3 days) and PMR symptoms disappeared. The patient had undergone total neck thyroidectomy and metastatic neck lymph node dissection three and six years after the onset of PMR, respectively. Nine months after the removal of metastatic lymph nodes, she was free of symptoms of PMR and peripheral blood lymphocyte response to mitogens was within the control range. PMR appeared to be a component of the long-standing paraneoplastic syndrome, induced by the tumor which had impaired cell-mediated immunity.