The articles by Brooks and McGee1 and Gonzalez-Gay et al2 describe the diagnostic dilemmas associated with polymyalgia rheumatica (PMR), especially in patients with atypical features and a normal erythrocyte sedimentation rate (ESR). Clinically, patients with PMR often present with initial thrombocytosis, a fact that has not been addressed in the literature. To examine the relevance of early thrombocytosis in PMR, we performed a retrospective study of 23 patients (14 women and 9 men; mean age, 67.3 years) who fulfilled Bird's diagnostic criteria1 for PMR after exclusion of individuals with disorders that have similar clinical manifestations, such as infections, malignant neoplasms, and collagen disorders. A prompt response to corticosteroid therapy was documented in all patients. Seven of the patients had biopsy-proved temporal arteritis, clinical details of which are described elsewhere.3 Platelet counts, ESR, and C-reactive protein (CRP) levels were monitored during diagnostic workup and for the first 3 weeks after initiation of corticosteroid therapy. Platelet counts were determined automatically (Cell-Dyn 3000 Multi-Angle Polarised Scatter Separation Laser Differential Device, Abbott Diagnostics, Delkenheim, Germany) (normal range, 150-400×109/L); ESR and levels of CRP were determined by standard methods.
Harten P, Seyfarth B, Löffler H. Thrombocytosis in Polymyalgia Rheumatica: An Additional Diagnostic Criterion and Possible Risk Factor for Ischemic Complications?. Arch Intern Med. 1998;158(1):95-96. doi: