[Myelodysplastic syndrome associated with polymyalgia rheumatica].

A 69-year-old man was referred to us because of severe pain in both girdles. A diagnosis of polymyalgia rheumatica was made, and low-dose prednisolone therapy (20 mg/d) was started. The patient's muscle pain disappeared after 3 weeks. After 5 months of therapy, pancytopenia became prominent. A marrow aspirate smear showed hypercellularity, trilineage dysplasia, and 7% blasts. The clinical diagnosis was myelodysplastic syndrome, subtype refractory anemia with excess of blasts. In elderly patients presenting with polymyalgia rheumatica, an underlying hematologic malignancy should always be looked for when the disease demonstrates clinical signs inconsistent with typical polymyalgia rheumatica.