Olfactory impairment in patients with the fibromyalgia syndrome and systemic sclerosis

Abstract

Patients with autoimmune diseases often present with olfactory impairment. The aim of the study was to assess the olfactory functions of female patients with fibromyalgia (FM) compared with patients with systemic sclerosis (SSc) and with healthy female controls. Olfactory functions were assessed in 24 patients with FM, 20 patients with SSc and 21 age-matched healthy controls. The sense of smell was evaluated using the Sniffin' Sticks test including the three stages of smell: threshold, discrimination, and identification (TDI) of the different odors. The severity of fibromyalgia was assessed using the fibromyalgia impact questionnaire (FIQ). The short form 36 (SF-36) questionnaire was also completed in order to seek a relationship between the patients perception of quality of life and the different aspects of the smell sense. Depression was evaluated in both FM and SSc patients utilizing the Beck depression inventory-II (BDI-II) questionnaire. Patients with FM had significantly lower TDI smell scores compared with both SSc patients and healthy controls (p < 0.005, One-Way ANOVA). Hyposmia (defined as TDI scores below 30) were observed in 14 of 24 (42 %) patients with FM compared to 3 of 20 (15 %) patients with SSc and 1 of the healthy controls (4.3 %) (p < 0.02). FM patients had significantly lower thresholds of smell compared to both healthy controls and patients with SSc (p < 0.001), whereas for patients with SSc only the ability to discriminate between odors was impaired (p < 0.006). We could not detect any statistical correlation between smell abilities and clinical manifestation of SSc or the FIQ and SF-36 scores among FM patients. However the correlation between depression, defined by the BDI-II score, and the sense of smell differed between patients with FM and patients with SSc. As only among SSc patients a lower sense of smell correlated with a higher BDI-II score (p = 0.02). Our findings suggest that there is a decrease in the sense of smell both in FM and SSc patients compared with healthy controls. However these impairments differ between patients group and might represent different mechanisms that affect the sense of smell.

The link between idiopathic intracranial hypertension, fibromyalgia, and chronic fatigue syndrome: exploration of a shared pathophysiology

“…Patients with IICH often show decreased olfactory bulb volumes91 and impaired olfactory function 9. These findings have also been reported for patients with FM 3. It is most likely that these symptoms are due to increased pressure compromising the blood supply and damaging the olfactory nerve cell bodies.…”

SARS-CoV-2, the autoimmune virus

“…We previously showed that olfactory dysfunction can be seen in a number of autoimmune diseases such as: SLE, multiple sclerosis and myasthenia gravis (MG) [ [43] , [44] , [45] ]. As for the above mention clear association between autoimmunity and the current COVID-19 pandemic, the recent observation of high prevalence of olfactory dysfunction, especially in the early presentation in COVID-19 patients - is not surprising [ 46 ].…”

Neuroimmunology: What Role for Autoimmunity, Neuroinflammation, and Small Fiber Neuropathy in Fibromyalgia, Chronic Fatigue Syndrome, and Adverse Events after Human Papillomavirus Vaccination?

“…[2]. The symptoms reported in FM, besides chronic widespread pain and tenderness, include diffuse stiffness, irritable bowel syndrome, fatigue/tiredness, thinking or memory problems, muscle weakness, headache, pain/cramps in the abdomen, numbness/tingling, dizziness, insomnia, depression, pain in the upper abdomen, pelvic pain, vulvodynia, nausea, nervousness, chest pain, blurred vision, fever, dry mouth, itching, wheezing, Raynaud’s phenomenon, hives/welts, ringing in the ears, vomiting, heartburn, oral ulcers, loss of/change in taste, hyposmia, seizures, dry eyes, shortness of breath, loss of appetite, rash, sun sensitivity, hearing difficulties, easy bruising, hair loss, frequent urination, painful urination and bladder spasms, orthostatic intolerance, and temporomandibular joint dysfunction [2,5,6,7]. A modified version of the 2010 criteria has replaced the physician’s estimate of the extent of somatic symptoms with the sum of six self-reported symptoms (fatigue, trouble thinking or remembering, waking up unrefreshed, pain or cramps in the lower abdomen, depression, and headache), making it simpler to use and maintaining sensitivity [8].…”