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

**Authors:** Ayato Nakagawa, Natsumi Yamamoto, Chiaki Sano, Ryuichi Ohta

PMC · DOI: 10.7759/cureus.66592 · Cureus · 2024-08-10

## TL;DR

An elderly man with multiple health issues was diagnosed with polymyalgia rheumatica and nephrotic syndrome, and his condition improved with corticosteroid treatment.

## Contribution

Highlights PMR as a potential cause of nephrotic syndrome in elderly patients and the effectiveness of low-dose prednisolone.

## Key findings

- Low-dose prednisolone improved joint pain, renal function, and overall condition in a nonagenarian.
- Polymyalgia rheumatica was associated with nephrotic syndrome and systemic inflammation in an elderly patient.
- Early diagnosis and treatment of PMR can enhance clinical outcomes and daily living in elderly patients.

## Abstract

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.

## Linked entities

- **Chemicals:** prednisolone (PubChem CID 5755)
- **Diseases:** polymyalgia rheumatica (MONDO:0019735), nephrotic syndrome (MONDO:0005377), aspiration pneumonia (MONDO:0000265)

## Full-text entities

- **Diseases:** inflammatory (MESH:D007249), fever (MESH:D005334), aspiration pneumonia (MESH:D011015), Nephrotic Syndrome (MESH:D009404), joint pain (MESH:D018771), PMR (MESH:D011111), hematuria (MESH:D006417)
- **Chemicals:** oxygen (MESH:D010100), PSL (MESH:D011239)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

20 references — full list in the complete paper: https://tomesphere.com/paper/PMC11385428/full.md

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Source: https://tomesphere.com/paper/PMC11385428