Fibromyalgia (FM) in lupus erythematosus

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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