Helicobacter pylori seropositivity in fibromyalgia syndrome

Abstract

Although there are some studies suggesting relation between different types of infection and fibromyalgia syndrome (FM), there is presently no proof that FM is caused by an infection. Helicobacter pylori (HP) infection may cause extragastric manifestations. Inflammation is an important mediator of increased sympathetic nervous system activity and may lead to pain in fibromyalgia patients. In this study, we aimed to investigate the HP seropositivity in fibromyalgia patients compared with controls for possible role of HP infection in FM. Sixty-seven patients with fibromyalgia were evaluated. Two of them were excluded from the study because of high level of acute phase reactants. Sixty-five female patients with fibromyalgia and 41 randomly selected age-matched female healthy controls were enrolled to study. Serum HP IgA and IgG antibodies were measured by enzyme-linked immunosorbent assay technique. Fibromyalgia Impact Questionnaire was assessed in patients and controls. Seropositivity of HP IgG antibody in the fibromyalgia patients was significantly higher than in the control group. No statistically significant differences were found regarding the clinical features between fibromyalgia patients with HP IgG antibody and patients without IgG antibody. Our study suggests that former HP infection may have a role in the etiopathogenesis of fibromyalgia syndrome or may act as a triggering factor. However, high seroprevalence of HP in general population and prevalent asymptomatic infection make it difficult to interpret these results for the definite role of HP in FM. Highlighting the pathophysiologic mechanisms of FM will result in more effective treatment regimens.

Fibromyalgia: A Critical and Comprehensive Review

“…In addition, an increased prevalence of FMS has been found in patients with hepatitis B virus, hepatitis C virus, HIV, human T cell lymphotropic virus, and Mycoplasma infections [401][402][403]. Conversely, there are some reports of higher seropositivity rates for certain infectious agents in FMS patients compared to healthy controls [401,404]. It has long been held that Lyme disease increases the risk of FMS, but a recent study showed that the incidence of FMS in patients with cultureconfirmed Lyme disease did not exceed that of the general population during long-term follow-up [405].…”

The Effects of Helicobacter Pylori Eradication on the Number of Tender Points, Sleep Quality, Depression, and Anxiety in Patients With Fibromyalgia

“…11,12 Studies focusing on extragastric manifestations of H. pylori infection such as sideropenic anemia and idiopathic thrombocytopenic purpura have been published, 5 however, literature regarding the effect of this microorganism on FMS is rather limited. 4 To date, only two studies investigated the possible association between H. pylori and FMS. In these studies, Malt et al 13 reported similar rates of H. pylori seropositivity in patients with FMS (n=28) and controls (n=39), while Akkaya et al 4 found that the prevalence of immunoglobulin (Ig) G anti-H. pylori antibodies was significantly higher in fibromyalgia patients (67.7%) compared to controls (43.9%).…”

“…4 To date, only two studies investigated the possible association between H. pylori and FMS. In these studies, Malt et al 13 reported similar rates of H. pylori seropositivity in patients with FMS (n=28) and controls (n=39), while Akkaya et al 4 found that the prevalence of immunoglobulin (Ig) G anti-H. pylori antibodies was significantly higher in fibromyalgia patients (67.7%) compared to controls (43.9%). However, among these patients, there were no significant differences in the clinical manifestations of FMS between H. pylori seropositive versus seronegative patients.…”

“…However, among these patients, there were no significant differences in the clinical manifestations of FMS between H. pylori seropositive versus seronegative patients. 4 The main symptom of FMS is widespread chronic pain. This is a neuropathic pain considered to be related to central nervous system sensitization and associated with sympathetic hyperactivity.…”

“…Although the possible association between various microorganisms and fibromyalgia have been investigated, there is rather limited literature regarding the role of Helicobacter pylori (H. pylori). 4 Helicobacter pylori is a gram-negative bacterium found in the stomach, however, in recent years there has been a growing interest in the subject of extragastric manifestations of H. pylori infection. 5 Some mechanisms such as the release of inflammatory mediators, molecular mimicry, and systemic immune response have been suggested for the extragastric involvement.…”