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Fibromyalgia (FM) syndrome in children & adolescents: clinical features at presentation & status at follow-up

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By Siegel DM, Janeway D, Baum J • www.ProHealth.com • March 20, 1998


OBJECTIVES: To 1) describe the characteristic features of
fibromyalgia syndrome (FS) in a pediatric population, 2) note
similarities and differences with FS in adults, and 3)
determine outcome after treatment.

SETTING AND DESIGN: The
Pediatric Rheumatology Clinic at the University of Rochester
Medical Center is staffed by two pediatric rheumatologists and
serves as a regional subspecialty referral service with
approximately 450 annual patient visits, of which
approximately 120 are initial evaluations. A retrospective
medical record review from 1989 to 1995 was used to identify
and describe the study population, and a structured telephone
interview served to determine current status and response to
treatment.

RESULTS: A total of 45 subjects were identified (41
female; 42 white; mean age, 13.3 years), of whom 33 were
available for telephone interview at a mean of 2.6 years from
initial diagnosis (0.1 to 7.6 years). Of a possible 15
symptoms associated with FS, subjects reported a mean of 8,
with >90% experiencing diffuse pain and sleep disturbance.
Less frequent were headaches (71%), general fatigue (62%), and
morning stiffness (53%). The mean cumulative number of tender
points summed over all visits was 9.7 (of 18). Telephone
interviews showed improvement in most patients, with a mean
positive change of 4.8 on a self-rating scale of 1 to 10
comparing current status to worst-ever condition.

CONCLUSIONS:
FS in patients referred to a pediatric rheumatology clinic is
characterized by diffuse pain and sleep disturbance, the
latter being more common than that in adults. The mean number
of tender points summed over all visits is fewer than the
criterion of 11 established for adults at a single visit. The
majority of patients improved over 2 to 3 years of follow-up.




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