Fibromyalgia is a musculoskeletal disorder characterized by
generalized myalgias, arthralgias widespread tender points in
discreet areas on examination. It is frequently accompanied by
fatigue, stiffness, and a nonrestorative sleep pattern. These
patients generally have a normal blood count and chemistry
profile. There is a subset of people with fibromyalgia (FM)
who test positive for the antinuclear antibody (ANA) and have
constitutional symptoms that resemble those of patients with
early lupus. We studied the immunologic profile of patients
with FM who are ANA-positive (+).
A retrospective review of patient records in a university-based
rheumatology practice was conducted. In a group of 66 FM patients,
30% (20) were ANA+, with a 75% preponderance of the speckled
pattern and 20% diffuse pattern. The remaining 5% were equally
split between diffuse-speckled and speckled-nucleolar patterns.
All had negative staining for extractable nuclear antibodies. The
Smart Index (SI), a ratio of the sedimentation rate to one-half the
patient's age, was developed to characterize each patient's
inflammatory response. The FM patients who were ANA negative (-)
had a mean SI of 0.55, whereas the FM patient's who were ANA+
had a SI of 1.07. These ANA+ patients represent a subgroup of
patients who have FM with an inflammatory response profile larger
than that of the ANA-patients.