PMR and thoracic aneurysm | Arthritis Information

I've read somewhere on the Net that PMR/GCA sufferers have a 17-fold chance of developing thoracic aortic aneurysm and that they should get a chest x-ray yearly to watch for this. Has anyone else been told of this? I recently went to a new doc (internist), as the last one I tried didn't want to treat PMR/GCA, and neither did the one before that. Well, this doc refused to order a chest x-ray as she said I don't have any risk factors for that type of aneurysm. She didn't even want to order a sed rate, but I insisted on one (it came back at 55). Needless to say, I'll be looking for another new doc. I did see a rheumy 2 years ago who had heard of the aneurysm problem but wasn't willing to treat me unless I tried methotrexate (no way). I'm just so fed up with doctors. At least I have several refills for prednisone. I read this forum often just to see what everybody is going through and how they are handling everything so I can manage this PMR/GCA thing myself. I'm hoping I soon can find a doc who will want to treat me and at least order the appropriate tests. Rheumys in my area seem to require a referral from another doc. So much for now.

Ima

May I ask the risks of methotrexate? I am unfamiliar with the meds used with pmr besides the predisone. Imainfp

visit the NMR Foundation website based in Arizona, they have information and might be able to steer you in the direction of a Rheumatologist.

Smprettylady

Google 'Methotextrate' and then read all the side effects. It is a chemotherapy drug and is used to replace pred eventually or on people who are intolerant of steroids. It is not a cure.

There is currently no known cause or cure for either PMR or GCA.

The decision is normally taken with the patient and the rheumatologist. The patient being fully aware of side effects from both pred and methotextrate. It is a personal decision.
Ima, I have had a check for thoracic aneurysm but it was done by ultrasound, not X-ray. I had the check because my mother died from the rupture of such an aneurysm. I'm wondering if pred doesn't weaken the blood vessel walls if PMR folks have such a high rate.Hi Bob--Yes, according to what I read, supposedly PMR and pred use does weaken vessel walls due to the constant inflammation and, hence, the increased risk for thoracic aneurysm. For some strange reason, the risk is much higher in the thoracic aorta as compared to the abdominal aorta. I wish I could find the article where I read about this and make a copy so I could present to a doctor who would finally agree on a chest xray. As you have had done, ultrasound is also a diagnostic tool, and so is CT scan, although chest xray is less expensive and can diagnose whether an aneurysm is present. If so, then a CT scan should be done, which can determine the exact size of the aneurysm.

As in your case Bob, you should definitely be scanned yearly, especially since your mom died of an aneurysm. I'm going to keep looking for that article about this subject.