POLYMYALGIA-RHEUMATICA IN MOROCCO

To study the clinical features and course of polymyalgia rheumatica in Morocco, patients seen between 1983 and 1993 were studied retrospecti vely. At least five diagnostic criteria for polymyalgia rheumatica wer e required, but no single criterion was obligatory. Of the 22 patients , 20 (90.9%) were women. Joint involvement in a typical distribution a nd severe deterioration of general health were the main clinical featu res, The erythrocyte sedimentation rate was greater than 50 mm/h in 83 % of patients and greater than 100 mm/h in 44%, One patient had giant cell arteritis and another a malignancy. Several findings were unusual . 1) The number of cases was small; during the same period, there were 444 new cases of rheumatoid arthritis and 354 of ankylosing spondylit is, This may be only partly due to the young age of the population in Morocco, since comparable low rates have been reported in a few other countries of the Mediterranean rim, suggesting a role of genetic facto rs. 2) Mean age in our series was 58 +/- 6.8 years, versus 65 years in the literature, and half our patients were younger than 60 years. Age at onset Is similarly low for rheumatoid arthritis and ankylosing spo ndylitis in Morocco, supporting an influence of environmental factors.