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Background: Immunosuppressive treatment of rheumatic diseases may be associated with several opportunistic infections of the brain. The differentiation between primary central nervous system (CNS) involvement and CNS infection may be [...]

We report the development of ureas as sterically undemanding pro-ligands for Pd catalysis. N-Arylureas outperform phosphine ligands for the Pd-catalyzed heteroannulation of N-tosyl-o-bromoanilines and 1,3-dienes, engaging diverse coupling partners for the preparation of 2-subsituted indolines, including sterically demanding substrates that have not previously been tolerated. Experimental and computational studies on model Pd-urea and Pd-ureate complexes are consistent with monodentate binding through the nonsubstituted nitrogen, which is uncommon for metal-ureate complexes.

We report velocity rotation events with amplitudes more than a few tens of kilometers per second observed by the Magnetospheric Multiscale mission. The events are detected in the outer magnetosphere near the magnetopause at approximately noon magnetic local time. When we examine one event, velocity and magnetic field variations are correlated. Accelerated electrons >100 eV are present. The azimuthal propagation direction is opposite to that of the background convection, implying that the structure and the background have different sources. The magnetic field variation can be approximately fitted to that of the line current. It is inferred that bundles of magnetic field lines with the same helicity propagate with the Alfvén velocity along the background magnetic field. One possible source is a flux transfer event. In addition, the variation in the solar wind dynamic pressure may also affect the velocity rotation. We have found 18 events during the first 2 years of Magnetospheric Multiscale operations. The derived properties are generally similar to those from the event study. For some events, we have identified a flux transfer event as a possible source. Again, the dynamic pressure variation may be the cause as well. The events reported resemble in some respects crewcuts and midday auroral brightening sequence, as measured by ground‐based optical instruments. Velocity rotation events are measured in the subsolar, outer magnetosphere with amplitudes more than a few tens of kilometers per secondAzimuthal directions of convective motion of structures are often opposite to those of background plasmasSome structures are inferred to be due to flux transfer events, although solar wind dynamic pressure variations may also be a cause

We investigate the agyrotropic nature of electron distribution functions and their substructure to illuminate electron dynamics in a previously reported electron diffusion region (EDR) event. In particular, agyrotropy is examined as a function of energy to reveal detailed finite Larmor radius effects for the first time. It is shown that the previously reported ∼66 eV agyrotropic “crescent” population that has been accelerated as a result of reconnection is evanescent in nature because it mixes with a denser, gyrotopic background. Meanwhile, accelerated agyrotropic populations at 250 and 500 eV are more prominent because the background plasma at those energies is more tenuous. Agyrotropy at 250 and 500 eV is also more persistent than at 66 eV because of finite Larmor radius effects; agyrotropy is observed 2.5 ion inertial lengths from the EDR at 500 eV, but only in close proximity to the EDR at 66 eV. We also observe linearly polarized electrostatic waves leading up to and within the EDR. They have wave normal angles near 90°, and their occurrence and intensity correlate with agyrotropy. Within the EDR, they modulate the flux of 500 eV electrons travelling along the current layer. The net electric field intensifies the reconnection current, resulting in a flow of energy from the fields into the plasma. The process of reconnection involves an explosive transfer of magnetic energy into particle energy. When energetic particles contact modern technology such as satellites, cell phones, or other electronic devices, they can cause random errors and failures. Exactly how particles are energized via reconnection, however, is still unknown. Fortunately, the Magnetospheric Multiscale mission is finally able to detect and analyze reconnection processes. One recent finding is that energized particles take on a crescent‐shaped configuration in the vicinity of reconnection and that this crescent shape is related to the energy conversion process. In our paper, we explain why the crescent shape has not been observed until now and inspect particle motions to determine what impact it has on energy conversion. When reconnection heats the plasma, the crescent shape forms from the cool, tenuous particles. As plasmas from different regions mix, dense, nonheated plasma obscures the crescent shape in our observations. The highest‐energy particle population created by reconnection, though, also contains features of the crescent shape that are more persistent but appear less dramatically in the data. We study agyrotropy and energy dissipation in an EDR event on the ion and electron inertial scalesAgyrotropy is observed 2.5 ion inertial lengths from the Xpoint at energies above the electron crescent populationAmplitude and occurrence of electrostatic, linearly polarized waves near fcecorrelate with increased agyrotropy in and around the EDR

We present Magnetospheric Multiscale observations of an electron-scale current sheet and electron outflow jet for asymmetric reconnection with guide field at the subsolar magnetopause. The electron jet observed within the reconnection region has an electron Mach number of 0.35 and is associated with electron agyrotropy. The jet is unstable to an electrostatic instability which generates intense waves with E?amplitudes reaching up to 300 mV m-1and potentials up to 20% of the electron thermal energy. We see evidence of interaction between the waves and the electron beam, leading to quick thermalization of the beam and stabilization of the instability. The wave phase speed is comparable to the ion thermal speed, suggesting that the instability is of Buneman type, and therefore introduces electron-ion drag and leads to braking of the electron flow. Our observations demonstrate that electrostatic turbulence plays an important role in the electron-scale physics of asymmetric reconnection. Electron outflow jet of asymmetric magnetic reconnection is observedElectron jet is unstable to Buneman-type instability generating intense electrostatic wavesThe instability leads to thermalization and braking of the electron jet

Zusammenfassung: Die Riesenzellarteriitis (RZA) manifestiert sich häufig als kraniale Arteriitis (z. B. Temporalarteriitis) mit Kopf- und Kauschmerzen sowie Sehstörungen. Nicht selten besteht jedoch auch eine extrakranielle Beteiligung, sodass die RZA gehäuft zu Aortenaneurysmen, Aortendissektionen und zu Stenosen der großen thorakalen, abdominellen oder der Extremitätenarterien führen kann. Begleitet wird die vaskulitische Symptomatik von unspezifischen Allgemeinbeschwerden (Malaise, erhöhte Temperaturen, Gewichtsabnahme, Depressionen), die bei älteren Menschen (>50 Jahre) an eine RZA denken lassen müssen. Die Polymyalgia rheumatica (PMR) stellt die häufigste rheumatische Manifestation der RZA dar, kann aber auch unabhängig von ihr auftreten. Als strukturelles Korrelat der PMR-Beschwerden kommen in erster Linie extraartikuläre Entzündungen (Tenosynovitis, Bursitis) großer Gelenke und der Wirbelsäule (interspinale Bursitis) in Betracht. Bei hoher Entzündungsaktivität der PMR muss zusätzlich an vaskulitische Entzündungen großer Gefäße gedacht werden. Während spezifische Laborparameter für die RZA und die PMR fehlen, haben erhöhte BSG- und CRP-Werte bei der Erstdiagnose eine hohe Sensitivität dieser relativ häufigen, Kortison-sensitiven Erkrankung des älteren Menschen. Neben der Klinik stellt die serologische Akute-Phase-Reaktion den wesentlichen Verlaufsparameter unter der Therapie dar.

Objectives. To determine the correlation between inflammatory cytokines and adrenal hormones in patients with polymyalgia rheumatica (PMR) and to compare the ratio of serum cortisol and androstenedione (ASD) or dehydroepiandrosterone sulphate (DHEAS) in normal subjects with PMR patients.Methods. In 102 patients with PMR (32 beginning and 70 chronic disease) and 31 age‐matched and sex‐matched healthy subjects, ASD, cortisol, DHEAS, interleukin‐6 (IL‐6), and tumour necrosis factor (TNF) were measured by immunometric assays.Results. Serum levels of IL‐6 were elevated in patients with PMR as compared with normal subjects (10.0 ± 1.6 vs 2.1 ± 0.1 pg/ml, P = 0.01), which was not found for TNF. In PMR patients, serum levels of IL‐6 were positively correlated with serum levels of ASD (P [lt ] 0.001), cortisol (P [lt ] 0.001), and DHEAS (P = 0.038) irrespective of corticosteroid treatment. Serum levels of cortisol in relation to IL‐6 were significantly lower in patients with chronic disease and long‐standing corticosteroid administration as compared with patients with recent onset of the disease and without corticosteroid therapy (P [lt ] 0.01).Conclusions. In PMR, as expected, there was an increase in IL‐6 serum levels that was associated with elevated serum levels of ASD, DHEAS, and cortisol which was more marked in patients with recent‐onset disease and without corticosteroids. However, serum levels of cortisol in patients with and without corticosteroids were lower than expected by considering the inflammatory status (increased IL‐6). This may indicate a change in the hypothalamic–pituitary–adrenal (HPA) axis responsiveness to inflammatory stimuli such as IL‐6 during chronic disease. Furthermore, there seems to be a shift of biosynthesis to cortisol in relation to DHEAS or ASD in chronic disease.

Objectives. To determine the correlation between inflammatory cytokines and adrenal hormones in patients with polymyalgia rheumatica (PMR) and to compare the ratio of serum cortisol and androstenedione (ASD) or dehydroepiandrosterone sulphate (DHEAS) in normal subjects with PMR patients.
Methods. In 102 patients with PMR (32 beginning and 70 chronic disease) and 31 age-matched and sex-matched healthy subjects, ASD, cortisol, DHEAS, interleukin-6 (IL-6), and tumour necrosis factor (TNF) were measured by immunometric assays.
Results. Serum levels of IL-6 were elevated in patients with PMR as compared with normal subjects (10.0 ± 1.6 vs 2.1 ± 0.1 pg/ml, P = 0.01), which was not found for TNF. In PMR patients, serum levels of IL-6 were positively correlated with serum levels of ASD (P [lt ] 0.001), cortisol (P [lt ] 0.001), and DHEAS (P = 0.038) irrespective of corticosteroid treatment. Serum levels of cortisol in relation to IL-6 were significantly lower in patients with chronic disease and long-standing corticosteroid administration as compared with patients with recent onset of the disease and without corticosteroid therapy (P [lt ] 0.01).
Conclusions. In PMR, as expected, there was an increase in IL-6 serum levels that was associated with elevated serum levels of ASD, DHEAS, and cortisol which was more marked in patients with recent-onset disease and without corticosteroids. However, serum levels of cortisol in patients with and without corticosteroids were lower than expected by considering the inflammatory status (increased IL-6). This may indicate a change in the hypothalamic-pituitary-adrenal (HPA) axis responsiveness to inflammatory stimuli such as IL-6 during chronic disease. Furthermore, there seems to be a shift of biosynthesis to cortisol in relation to DHEAS or ASD in chronic disease.

We present the first electron time-of-flight measurements obtained with the Electron Drift Instrument (EDI) on Equator-S. These measurements are made possible by amplitude-modulation and coding of the emitted electron beams and correlation with the signal from the returning electrons. The purpose of the time-of-flight measurements is twofold. First, they provide the drift velocity, and thus the electric field, when the distance the electrons drift in a gyro period becomes sufficiently large. Second, they provide the gyro time of the electrons emitted by the instrument, and thus the magnitude of the ambient magnetic field, allowing in-flight calibration of the flux-gate magnetometer with high precision. Results of both applications are discussed.

We present the first triangulation measurements of electric fields with the electron drift instrument (EDI) on Equator-S. We show results from five high-data-rate passes of the satellite through the near-midnight equatorial region, at geocentric distances of approximately 5–6 RE, during geomagnetically quiet conditions. In a co-rotating frame of reference, the measured electric fields have magnitudes of a few tenths of mV/m, with the E × B drift generally directed sunward but with large variations. Temporal variations of the electric field on time scales of several seconds to minutes are large compared to the average magnitude. Comparisons of the “DC” baseline of the EDI-measured electric fields with the mapped Weimer ionospheric model and the Rowland and Wygant CRRES measurements yield reasonable agreement.

A lectin from the marine sponge GEODIA CYDONIUM was isolated and characterized. GEODIA lectin (GL) agglutinates human red blood cells irrespective of the ABO blood group and precipitates with a variety of D-galactose containing glycosubstances, i.e. certain snail galactans, bovine erythrocyte glycoprotein and PNEUMOCOCCUS type XIV polysaccharide. The only simple sugars inhibiting the GL-mediated hemagglutination were lactose and n-acetyl-D-galactosamine.

The aggregation receptor (AR) from the marine sponge GEODIA CYDONIUM was analyzed with respect to its monosaccharide composition. Three major sugars (D-galactose, D-glucose and D-glucuronic acid) accounted for about 85 % of the total carbohydrate. Negative results with different lectins directed against D-galactosyl, N-acetyl-D-galactosaminyl and N-acetyl-D-glucosaminyl groups, respectively, showed that these sugars are serologically unreactive in AR. Positive serological reactions were obtained with CONCANAVALIN A and LIMULUS POLYPHEMUS agglutinin. AR also reacted strongly with the basic polymer poly-L-lysine. Reaggregation experiments performed on the basis of these findings strongly suggest that AR-bound D-glucuronic acid is recognized by an intercellular aggregation factor (AF) during the secondary aggregation of GEODIA cells.

Summary A 17-year-old female with a 5-year history of disseminated lupus erythematosus has remained without immunosuppressive therapy for the last 3 years. She was admitted to the hospital for acute abdominal pain, generalized edema, and rapidly developing dyspnea and somnolence. Al-though all symptoms were consistent with active SLE, septicemia was suspected because of leukocytosis (20,000/?l), greatly elevated C-reactive protein (45 mg/dl), and normal complement values (C3 0.74 g/l, C4 0.21 g/l). Directly after bacterial blood cultures were prepared, a combined treatment was instituted consisting of plasmapheresis (3×2.1 l against fresh frozen plasma), antibiotics, prednisolone, and cyclophosphamide following the last plasmapheresis. Within three days cerebral function returned to normal, edema improved, and CRP fell to 0.5 mg/dl. The blood cultures and pericardial effusion displayed meningococcal colonies.

Zusammenfassung: Psychische Strungen knnen bei zahlreichen immunologischen Systemerkrankungen auftreten. Hufig sind sie ein frhes Krankheitssymptom, gelegentlich sogar das prsentierende Symptom. Die vorliegende Arbeit gibt eine bersicht ber das Vorkommen psychischer und neurologischer Symptome bei verschiedenen immunologischen Systemerkrankungen wie dem systemischen Lupus erythematodes, dem Sjgren-Syndrom, den primren Vaskulitiden und anderen Immunopathien wie dem Antiphospholipidsyndrom und dem Sneddon-Syndrom. Darber hinaus werden Leitlinien zum differentialdiagnostischen Vorgehen und zur Therapie bei Verdacht auf eine immunologische Systemerkrankung als Ursache einer psychischen Strung dargelegt und diskutiert. Durch Beachtung der gegebenen Leitlinien kann es in Einzelfllen psychischer Strungen gelingen, eine immunologische Systemerkrankung als Ursache der psychischen Strung zu identifizieren und so frhzeitig eine kausale Therapie einzuleiten.

We present a case of Sneddon's syndrome with high titers of antiphospholipid antibodies (APLA), in which the leading symptom was an incapacitating memory defect. MRI revealed vasculitic lesions of the central nervous system (CNS). Therefore immunosuppressive therapy was started with steroids and cyclophosphamide pulses. The transient beneficial effects of such a therapy will be discussed.

An immunoglobulin-independent deposition of the complement (C) components C4 and C3 occurs on rat kidney medullary structures, when sera of patients with various inflammatory diseases are studied by indirect immunofluorescence. The diagnostic value of this new test (C4-C3-IFT) for polymyalgia rheumatica (PMR) is stressed, since all sera from patients with active disease yielded positive reactions. Though highly sensitive with respect to PMR, C4/C3-IFT is not specific for this syndrome. Examples of positive reactions in systemic inflammatory diseases other than PMR are documented. Besides the clinical studies, C4/C3-IFT reactivity was analyzed with regard to the mechanisms of the reaction. Experimental data are presented which suggest that C-reactive protein (CRP) binds to rat kidney structures, thereby activating the classical C cascade. As a result of CRP-C interaction, C4 and C3 components are fixed to distinct renal medullary structures. Because of its technical simplicity, C4/C3-IFT can routinely be used to screen patients' sera for CRP-mediated C activation. This ex vivo test system may contribute to a better understanding of pathophysiological functions of serum CRP in various inflammatory diseases.

Using indirect immunofluorescence deposition of complement C4 and C3 components to rat kidney medullary structures was demonstrated. This serological reaction (C4/C3-IFT) is regularly obtained with fresh sera of patients suffering from active polymyalgia rheumatica (PMR) and/or giant cell (temporal) arteritis (GCA). Sera of normal controls and of steroid-treated PMR and/or GCA patients in clinical remission have a negative C4/C3-IFT reaction. A positive conversion of the test in steroidtreated patients indicates enhanced disease activity. Because of its technical simplicity, C4/C3-IFT can be routinely used first, as a reliable serological marker in the primary diagnosis of PMR and/or GCA and second, as a sensitive criterion of disease activity in these patients. C4/C3-IFT reactivity is, however, not specific for GCA and/or PMR. Various systemic inflammatory diseases may have a positive reaction as well (e.g., certain viral and bacterial infections, malignant tumors, vasculitides, inflammatory joint diseases of different etiology). Recent experimental findings suggest that C-reactive protein (CRP) in patients' sera mediates an activation of the classical complement pathway resulting in a deposition of C4 and C3 complement components to certain rat kidney structures.

Abstract: Our objective was to study the value of 99mtechnetium-pyrophosphate (99mTc-PYP) muscle scintigraphy and magnetic resonance imaging (MRI) in detecting areas of likely muscle inflammation and in increasing the rate of positive muscle biopsies in patients with suspected myositis. The results showed that in 13 out of 13 patients with clinical and/or signs of inflammatory muscle disease, increased 99mTc-PYP uptake was demonstrated at different muscle sites 3 h after isotope injection. Subsequent MRI of symmetric muscle areas with enhanced 99mTc-PYP uptake revealed signal patterns suggesting inflammation in all cases. Biopsy of these targeted muscles demonstrated characteristic histopathologic signs of muscle inflammation in 9 out of 13 patients. Four of these 9 patients had clinically atypical disease or did not show elevated creatine phosphokinase levels. Seven of these 9 patients had not been pretreated with corticosteroids. In 4 patients only muscle fiber atrophy and/or necrosis without cellular infiltrations was seen. These 4 patients had received either high doses of corticosteroids or low doses over longer periods of time before muscle biopsy. In conclusion, the combination of 99mTc-PYP muscle scintigraphy and MRI demonstrated muscle areas with maximum inflammatory signal patterns. Targeting of muscles by MRI only will probably yield reliable results of muscle biopsy in cases of clinically and serologically characteristic myositis. 99mTc-PYP muscle scintigraphy may provide useful initial information about localization of inflamed muscle tissue, especially in atypical disease. Treatment with corticosteroids prior to histologic diagnosis may abolish inflammatory infiltrations in affected muscle tissue.

The Electron Drift Instrument (EDI) measures the drift of a weak beam of test electrons that, when emitted in certain directions, return to the spacecraft after one or more gyrations. This drift is related to the electric field and the gradient in the magnetic field, and these quantities can, by use of different electron energies, be determined separately. As a by-product, the magnetic field strength is also measured. The present paper describes the scientific objectives, the experimental method, and the technical realization of the various elements of the instrument.

The electron drift instrument (EDI) on Cluster pioneered a new method of measuring electric fields, using a beam of electrons to sample the drift velocity over a km‐scale gyro orbit. The technique is especially well suited to measuring weak, sub‐mV/m, convection fields due to its sensitivity (to both components in the plane perpendicular to B) and because it is unaffected by the anomalous local electric fields that are generated by spacecraft‐plasma interactions. Because EDI requires exquisite beam pointing with active tracking of the firing directions, measurements are less regular, or even impossible, in rapidly varying electric and magnetic fields; however, in the many regimes where tracking is successful the resulting measurements are reliably accurate. We review the EDI technique and instrumentation, and present six areas of investigation using Cluster data: (1) Detailed comparisons of EDI data with the electric field and waves double probe measurements show excellent agreement in many cases but identify large discrepancies where strong ion outflow in the polar regions creates local spacecraft wake effects. (2) The wake effect is exploited to infer quantitative ion outflow rates. Detailed convection patterns in the (3) polar cap, (4) lobe, and (5) inner magnetosphere are derived under various driver conditions using statistical analyses of long term measurements during the Cluster mission. (6) EDI's large geometric‐factor detector is used for extremely high time resolution measurements of electrons at a specified energy and pitch angle. Complementarity of electron drift and double‐probe techniques establishedInner magnetosphere, polar cap, and tail‐lobe convection patterns determinedKey contribution to ion outflow velocities made Complementarity of electron drift and double‐probe techniques established Inner magnetosphere, polar cap, and tail‐lobe convection patterns determined Key contribution to ion outflow velocities made

A dipolarization of the background magnetic field was observed during a conjunction of the Magnetospheric Multiscale (MMS) spacecraft and Van Allen Probe B on September 22, 2018. The spacecraft were located in the inner magnetosphere at L∼ 6–7 just before midnight magnetic local time (MLT). The radial separation between MMS and Probe B was ∼1RE. Gradual dipolarization or an increase of the northward component BZof the background field occurred on a timescale of minutes. Exploration of energization and Radiation in Geospace located 0.5 MLT eastward at a similar Lshell also measured a gradual increase. The spatial scale was of the order of 1 RE. On top of that, MMS and Probe B measured BZincreases, and a decrease in one case, on a timescale of seconds, accompanied by large electric fields with amplitudes > several tens of mV/m. Spatial scale lengths were of the order of the ion inertial length and the ion gyroradius. The inertial term in the momentum equation and the Hall term in the generalized Ohm's law were sometimes non‐negligible. These small‐scale variations are discussed in terms of the ballooning/interchange instability and kinetic Alfvén waves among others. It is inferred that physics of multiple scales was involved in the dynamics of this dipolarization event. A dipolarization was observed during a conjunction of Magnetospheric Multiscale and Van Allen Probe B in the inner magnetosphereA BZincrease on a timescale of minutes was overlaid with those on a timescale of secondsThe inertial term and the Hall term sometimes played a role during BZincreases on a timescale of seconds A dipolarization was observed during a conjunction of Magnetospheric Multiscale and Van Allen Probe B in the inner magnetosphere A BZincrease on a timescale of minutes was overlaid with those on a timescale of seconds The inertial term and the Hall term sometimes played a role during BZincreases on a timescale of seconds

OBJECTIVE: The functional variant C77G (rs17612648) of PTPRC (CD45) was described to confer risk for systemic sclerosis (SSc) in German Caucasians. We analyzed this association in an independent, larger German cohort. METHODS: We genotyped 171 cases and 179 controls. Cases were subgrouped according to sex, autoantibody profiles, or clinical subsets. RESULTS: No association of SSc with C77G was detected in the whole dataset, in subgroups, or in combined analyses with a previous study. CONCLUSION: The results do not confirm PTPRC C77G as a general and independent risk factor for development of SSc.

Glycoprotein B (gB) is involved in cell to cell transmission of human Cytomegalovirus (HCMV) and may be a critical factor in tissue tropism and viral pathogenesis. We analyzed the distribution of the four known gB genotypes of HCMY in 99 HIV-positive patients. 29 patients had HCMV retinitis, and 70 patients had asymptomatic HCMV infection. DNA was isolated from blood, urine, and aqueous humor, and gB genotypes were determined by PCR and restriction analysis. Infections with gB type 1 were less frequent in patients with retinitis than in patients with asymptomatic HCMV infection (17% versus 37%; p = 0.05). Furthermore, the gB type was correlated with dissemination of infection. In patients with HCMV detected in only one compartment (blood or urine) the gB type 1 was found more frequently than in patients with HCMV detected in at least two compartments (p = 0.01). The data show that gB genotypes differ in their association with clinical disease, and indicate that the gB genotype may contribute to the course of HCMV infection.

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<it>Objectives</it>. Hyperprolactinaemia has been associated with the active phase of human systemic lupus erythematosus and rheumatoid arthritis. In the present study, we investigated the role of prolactin (PRL) in relation to the number of typical symptoms and serum markers of systemic inflammation in patients with polymyalgia rheumatica (PMR). <it>Methods</it>. One hundred and two PMR patients presented with typical symptoms such as adynamia, bilateral muscular pain in shoulders, upper arms or neck, bilateral muscular pain in the pelvic girdle, headache, morning stiffness, arthralgia, symptoms of depression, fever, initial weight loss (>4 kg/month), and transient visual symptoms. If one of the mentioned symptoms was present, the corresponding item was scored with one point (maximum unweighted item points=10). PRL, interleukin‐2 (IL‐2), IL‐6, IL‐1 receptor antagonist (IL‐1ra), tumour necrosis factor (TNF), soluble IL‐2 receptor (sIL‐2R), and soluble vascular cell adhesion molecule (sVCAM) were measured by enzyme‐linked immunosorbent assay in patients and 31 age‐matched healthy controls. <it>Results</it>. Fifteen PMR patients with elevated PRL had a higher number of symptoms as compared with patients with normal levels (<it>P</it>=0.003). PRL was correlated with the number of symptoms (all PMR patients: <it>r</it><inf>rank</inf>=+0.380, <it>P</it><0.001) and duration of morning stiffness (all PMR patients: <it>r</it><inf>rank</inf>=+0.335, <it>P</it>=0.002) irrespective of prior corticosteroid treatment. However, PRL did not correlate with markers of systemic inflammation such as erythrocyte sedimentation rate, C‐reactive protein, serum IL‐1ra, IL‐2, sIL‐2R, IL‐6, TNF, and sVCAM. <it>Conclusion</it>. The number of symptoms in PMR patients was positively correlated with PRL, but PRL was not correlated with serum markers of inflammation. This indicates that PRL is not a pro‐inflammatory stimulus in patients with PMR. The inter‐relationship between PRL and symptoms or duration of morning stiffness may be more a sign of central nervous system involvement, as it can be observed in people with depressed mood or under psychological stress.