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From: The Rheumatologist, May 2013

Letters: More on the History of Polymyalgia Rheumatica and Giant Cell Arteritis

by Charles Plotz, MD, and William P. Docken, MD

I just got the March 2013 article with the nice cover portrait of Giamberti and his temporal artery. The accompanying article by your colleague William Docken was excellent, too, but not quite complete.

Of course the syndrome of PMR and giant-cell arteritis was well known long before Barber named it, but was completely ignored in the U.S. literature until there was a single case report by Calabro that was followed by the report of 11 cases from my clinic at Mount Sinai Hospital in New York (Davison S, Spiera H, and Plotz C.M. Arthritis Rheum. 1966;9:18–23). Articles on treatment followed.

It has always been gratifying to note that more recent years have spurred interest in this syndrome by Andy Healey, Gene Hunder, and many others. It is strange that the first published report did not appear until ours in 1966.

Charles Plotz, MD
Emeritus Professor of Medicine SUNY Health Science Center, Brooklyn, N.Y.

Dr. Docken Weighs In

Thank you for your e-mail. Constraints of space did not permit me to provide a fuller history of PMR/GCA, and to acknowledge all of those in the field who have brought these diseases to the attention of the rheumatologic community. I cited Barber not as the first doctor who recognized PMR, but as the one who, I believe, first coined the term (based on the mistaken notion—he was a neurologist!—that PMR was a condition of the muscles, rather than of the joints and bursae). You are correct that John Calabro was the first to author a paper on the topic from this side of the Atlantic, followed not long after by your paper.

It is indeed strange that it took quite so long for PMR/GCA to emerge into rheumatologic consciousness; Arthur Hall, a long-time member of our division, who recently died, used to muse, apropos of PMR, while puffing on his ever-present pipe, “I wonder what we used to call this years ago... .” Man sieht nur was man weiß, as Goethe opined.

I do think that Andy Healey’s correct insistence on PMR as a disorder of joints in the 1980s and early 1990s has been underrecognized. I have a hand-written note from Dr. Healey dating from 1989—still affixed to the bulletin board in my office—in response to a rather minor article of mine in the old Rheumatic Disease Clinics of North America on the uses of low-dose prednisone, where I discussed PMR as disorder of joints and referenced several of Dr. Healey’s publications. In his letter, Dr. Healey thanked me for the article, and—rather poignantly, I have always thought—added, “For a long time, it seemed no one was listening.”

William P. Docken, MD
Senior Physician, Brigham and Women’s Hospital, Assistant Professor of Medicine
Harvard Medical School, Boston

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