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Fibromyalgia (FM) in lupus erythematosus

  [ 25 votes ]   [ Discuss This Article ] • January 5, 1999

Fibromyalgia has been reported to occur with high prevalence in
systemic lupus erythematosus. Data on fibromyalgia in other
subsets of lupus erythematosus are not available. Risk factors
for fibromyalgia have not been defined. We investigated 60
patients with different subsets of lupus erythematosus for the
presence of fibromyalgia, association with clinical and
laboratory parameters and disease activity. Our data were
compared with the multicentre lupus erythematosus registry at
the Free University of Berlin. Ten out of 60 patients with
more than 11 tender points and widespread pain for more than 3
months were classified as positive for fibromyalgia. All of
them were female. Fibromyalgia-positive patients suffered
significantly more often from headache, morning stiffness,
diffuse alopecia, muscle pain, arthralgia, renal involvement,
and disclosed peripheral blood cell cytopenia, rheumatoid
factor, hypergammaglobulinaemia and intake of corticosteroids
and azathioprine. Fibromyalgia was more frequent in systemic
lupus than in other lupus subsets. Evaluation of fibromyalgia
symptoms and lupus disease activity was performed in 30
patients in a 1- year (range 9-13 months) follow-up. These 30
patients consisted of 9 fibromyalgia-positive and 21
fibromyalgia-negative patients. Both groups were characterized
by stable clinical features such as number of tender points
and ECLAM index. Fibromyalgia did not show a correlation with
lupus activity. We suggest that fibromyalgia and lupus
erythematosus are distinct complaints. Patients with lupus are
at risk of developing secondary fibromyalgia. The clinical
features of fibromyalgia-positive patients may contribute to
misinterpretation of lupus activity.

Grafe A, Wollina U, Tebbe B, Sprott H, Uhlemann C, Hein G

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