Prevalence and factors associated with fibromyalgia in Mexican patients with systemic lupus erythematosus

Abstract

In total, 189 consecutive women diagnosed with SLE were evaluated using the ACR 1990 criteria for fibromyalgia. Patients were classified into three subgroups. The fibromyalgia group (FM) included patients experiencing pain on palpation in at least 11 of the 18 tender points examined, as well as having a history of widespread pain for at least three months. Patients who were noted to have pain in fewer than four quadrants with less than 11 of 18 tender points were considered to have regional pain (RP). All patients who did not meet criteria for either FM or RP were classified as having no pain (NP). Measurement of SLE disease activity, sleep complaints, depression, fatigue severity and health status were performed. Only 18 of the SLE patients (9.5%) (95% CI 5.3-14%) fulfilled the ACR criteria for the classification of FM. Of the patients, 106 (56.1%) fulfilled criteria for RP and had a number of tender points of 5.4 +/- 3.4, and the rest of the patients (34.4%) had no tenderness at specific tender point sites. Age, body mass index, educational level and disease duration were comparable between the groups. FM and RP groups had different patterns of symptoms prevalence, with dysmenorrhea being more distinctive for FM. Sleep disturbances were more severe in the FM than in the RP group. Daytime complaints such as sleepiness, fatigue and depression were similar for RP and FM groups, but patients with FM reported more disability. Fibromyalgia is not common in Mexican patients with SLE and has a different pattern of symptoms in RP and NP patients. These data add evidence that ethnicity can play an important role in FM manifestations.

Fibromyalgia, Systemic Lupus Erythematosus (SLE), and Evaluation of SLE Activity

“…In an Indian tertiary referral center cohort, Handa et al found fibromyalgia in 8.2% of 158 patients (6). In a Mexican clinic, Valencia-Flores et al reported 9.5% of 106 SLE patients satisfied ACR criteria (7). In the LUMINA (lupus in Minorities) study, Friedman et al reported a prevalence of fibromyalgia of 5% in 266 SLE patients (8).…”

“…The issue of SLE and fibromyalgia has been approached by a number of investigators (3)(4)(5)(6)(7)(8)(9). Two approaches to the problem have included trying to distinguish persons with fibromyalgia from those with SLE and identifying persons with SLE who also have fibromyalgia.…”

A associação fibromialgia e lúpus eritematoso sistêmico altera a apresentação e a gravidade de ambas as doenças?

“…10 A literatura já apontou uma maior prevalência de FM mais em pacientes com LES do que na população geral. A prevalência identificada de FM nos pacientes com LES no presente estudo foi de 12%, discretamente menor do que a encontrado na literatura, [16][17][18][19][20][21][22] que varia entre 17% e 22%. À avaliação das características da dor e a intensidade dos sintomas por meio dos questionários EVA, IDG e ISS, observaram-se os piores desempenhos nos grupos que apresentam FM isolada ou associada.…”

“…15 A associação da FM e do LES tem sido investigada por vários autores, com resultados conflitantes em relação ao impacto de uma condição na outra. [16][17][18][19][20][21][22] A prevalência da associação da concomitância entre as duas doenças encontra-se em torno de 20%. 16 Assim, a presença de FM em pacientes com LES é muito maior do que na população geral.…”

Impact of Number of Fibromyalgia Tender Points on Disease Activity in Systemic Lupus Erythematosus Patients

“…Moreover, in this series no significant correlation was observed in SLEDAI (r= +0.085, p = 0.495) with disease duration as shown in Table-VII. 15 . They observed nearly similar mean ages among the 3 subgroups (37.8±11.3, 39±13.4 and 39.8years respectively).…”