Are patients with systemic lupus erythematosus at increased risk for Fibromyalgia?

Journal: Current Rheumatology Reports. 2006, December, 8(6):430-435. Author and affiliation: Roland Staud. Department of Medicine, McKnight Brain Institute, University of Florida, Gainesville, Florida. [E-mail] PMID: 17092442

Widespread chronic pain, fatigue, and distress do not represent risk factors for future systemic lupus erythematosus (SLE) or other autoimmune syndromes. On the other hand, SLE seems to be a significant risk factor for Fibromyalgia (FM).
n Up to 47% of SLE patients fulfill FM criteria.
n SLE patients with concomitant FM are often highly symptomatic and dysfunctional.
n The presence of FM symptoms in SLE patients, however, does not predict more extensive organ involvement or lupus activity.
n The high concordance of SLE with FM suggests common mechanisms related to pain and distress in both patient groups.
n Recent research suggests involvement of N-methyl-d-aspartate (NMDA) and neurokinin receptor systems.
n Thus, autoimmune activity against these receptor systems in SLE patients could result in pain, cognitive defects, and chronic pain states including FM.
n Conversely, treatment of SLE-FM patients with inhibitors of NMDA or neurokinin receptors may prevent or alleviate cognitive abnormalities and chronic pain, as well as FM.

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