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Sarı N, Kulaklı S, Oğuz ID, Akşan B, Sarı İF. Evaluation of fibromyalgia frequency and quality of life in Notalgia paresthetica patients. Arch Dermatol Res 2024; 316:317. [PMID: 38822886 PMCID: PMC11144133 DOI: 10.1007/s00403-024-03027-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 04/21/2024] [Accepted: 04/26/2024] [Indexed: 06/03/2024]
Abstract
Based on the presence of chronic pain and the potential use of common treatment agents in Notalgia Paresthetica (NP) and Fibromyalgia Syndrome (FMS) for improvement, we aimed to investigate the frequency of FMS symptoms in NP patients and its impact on quality of life. This study is a case control cohort study including 26 patients diagnosed with NP and a total of 26 controls matched for age and gender. The 2016 revised fibromyalgia diagnostic criteria by the American College of Rheumatology (ACR) were used to inquire about FMS diagnosis criteria in the study. According to the 2016 ACR revised FMS diagnostic criteria, the frequency of FMS was significantly higher in the patient group (n = 9, 34.6%) compared to the control group (n = 2, 7.7%) (p = 0.042). The Wide Pain Index (WPI) score in the control group was 2.00 (3.25), while in the patient group, it was 4.00 (8.00), with a statistically significant difference between them (p < 0.035). Furthermore, significant statistical differences were found between the two groups in terms of Symptom Severity Scale (SSS), Fibromyalgia Score (FS), and FIQ (p < 0.035, p < 0.001, p < 0.001, respectively). In NP patients with accompanying FMS, Dermatology Life Quality Index was significantly more affected compared to those without FMS (p = 0.025). In conclusion, we recommend that NP patients be questioned about FMS, which is characterized by generalized pain, as well as regional neuropathic symptoms. Treatment success can be enhanced by using common agents in the treatment choice for accompanying FMS.
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Affiliation(s)
- Nihal Sarı
- Department of Dermatology and Venereology, Bulancak State Hospital, Giresun, Turkey.
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey.
| | - Sevgi Kulaklı
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Işıl Deniz Oğuz
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - Burak Akşan
- Department of Dermatology and Venereology, Faculty of Medicine, Giresun University, Giresun, Turkey
| | - İlker Fatih Sarı
- The Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Giresun University, Giresun, Turkey
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Plant K, Goebel A, Nair J, Moots R, Chadwick L, Goodson N. Characteristics of pain and their relationship to disease activity in UK patients with Behçet's syndrome: a prospective cohort study. Br J Pain 2023; 17:560-568. [PMID: 37969132 PMCID: PMC10642501 DOI: 10.1177/20494637231198200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023] Open
Abstract
Background Behçet's syndrome (BS) is a rare multi-systemic vasculitis of unknown aetiology. Fibromyalgia syndrome (FMS) is more prevalent in rheumatological conditions such-as BS, than the general population. However, there is limited research into the aetiology and characteristics of pain in BS. Objectives To describe the pain characteristics and incidence of FMS in people with BS and investigate their relationship with BS disease activity. Methods A cohort study of BS patients attending the Liverpool Behçet's Centre between February 2017 and March 2019. BS was defined using the International Study Group Criteria. BS severity was assessed using the Behçet's Disease Current Activity Form. FMS was determined from consultant diagnosis. Assessments of pain included: Pain Visual Analogue Scale (PVAS), Pain Mannequin, Brief Pain Inventory, EQ-5D-3L and Short Form McGill. Pain and FMS prevalence were compared between high and low disease activity. Results 90% reported moderate-severe pain with a median PVAS score of 68/100 [38, 81]. 35.6% of participants had FMS and 46.5% experienced generalized pain. 76% of participants with high disease activity reported severe pain, compared to 39.1% with low disease activity (p = .003). Pain was more generalised in high disease activity (72%) compared to low disease activity (37.7%) (p = .003). FMS was more prevalent in the high disease activity group (52%) than the low disease activity group (29%) (p = .04). Conclusions This is the first study to explore pain in participants with BS in the United Kingdom. The majority of BS patients experience moderate-severe widespread pain. Severe widespread pain is more prevalent in those with high disease activity. We have demonstrated a relationship between high disease activity, worse pain intensity, and FMS. This paper contributes to the understanding of two conditions which remain to be fully understood, FMS and BS, and generates new hypotheses to describe the interplay between.
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Affiliation(s)
- K Plant
- Department of Rheumatology, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
- Faculty of Health and Life Sciences, Liverpool University, Liverpool, UK
| | - A Goebel
- Pain Research Institute, University of Liverpool, Liverpool, UK
- Department of Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - J Nair
- Department of Rheumatology, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
- Department of Rheumatology, National Behcet’s Centre of Excellence, Liverpool, UK
| | - R Moots
- Department of Rheumatology, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
- Department of Rheumatology, National Behcet’s Centre of Excellence, Liverpool, UK
| | - L Chadwick
- Department of Rheumatology, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
| | - N Goodson
- Department of Rheumatology, Liverpool University Hospital NHS Foundation Trust, Liverpool, UK
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Altıntas D, Melikoglu MA. The frequency of fibromyalgia in familial Mediterranean fever and its impact on the quality of life. Int J Rheum Dis 2022; 25:1123-1128. [PMID: 35851993 DOI: 10.1111/1756-185x.14389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/02/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Concomitant fibromyalgia syndrome (FMS) has been known to be more frequent in patients with several rheumatic diseases. In this study, our aim was to investigate the prevalence of FMS in patients with familial Mediterranean fever (FMF), to analyze the possible factors related to this frequency, and to evaluate the impact of FMS on the functionality and quality of life (QoL) of the patients with FMF. PATIENTS AND METHODS One hundred cases with FMF and 100 controls were included to this case-control study. FMS coincidence was investigated in all participants according to revised 2016 classification criteria. Demographic features, FMF disease duration, FMF gene mutations, drugs used, attack frequency per year, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum fibrinogen levels were recorded. FMF disease severity was assessed by International Severity Scoring System for Familial Mediterranean Fever (ISSF). For the assessments of QoL and functioning, FMF-QoL, Short form 36 (SF-36), and Health Assessment Questionnaire-Disability Index (HAQ-DI) were used, and for the assessment of FMS impact, the fibromyalgia impact questionnaire (FIQ) were used. RESULTS We found an FMS frequency of 33% in patients with FMF in our study using the current FMS classification criteria. This result was significantly higher than in age- and gender-similar controls (6% FMS frequency; P < 0.05). The number of woman patients and FMF disease duration were significantly higher in patients with FMF + FMS than in patients with only FMF (P < 0.001). There was no significant difference in ISSF scores, ESR, CRP, and fibrinogen levels, management regimens, and FMF gene mutation distributions between FMF + FMS and FMF groups. FMF attack frequency was reported as significantly higher in FMF + FMS patients than in others (P < 0.000). In spite of similar FMF-QoL scores, there were significant differences in HAQ-DI and SF-36 scores between groups (P < 0.05). Higher impact of FMS presented negative correlation with functioning and general health, and positive correlation with QoL in FMF + FMS (P < 0.05). CONCLUSION Concomitant FMS was a common clinical problem in patients with FMF regardless of the severity and characteristics of FMF. The FMS impact may affect function and QoL in patients of FMF. Considerations of the FMS component in the management of FMF may contribute to the holistic approach to FMF.
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Affiliation(s)
- Duygu Altıntas
- Physical Medicine and Rehabilitation Sivas State Hospital Sivas Turkey
| | - Meltem Alkan Melikoglu
- Rheumatology Division, Physical Medicine and Rehabilitation Department Ataturk University School of Medicine Erzurum Turkey
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Ayar K, Metİn Ökmen B, Altan L, KÖsegİl ÖztÜrk E. The Frequency of Fibromyalgia and its Relationship With Disease Activity in Female Patients With Behçet's Disease: A Cross Sectional Study. Arch Rheumatol 2020; 35:401-408. [PMID: 33458664 PMCID: PMC7788660 DOI: 10.46497/archrheumatol.2020.7729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/28/2019] [Indexed: 11/03/2022] Open
Abstract
Objectives This study aims to determine the incidence of fibromyalgia (FM) in female patients with Behçet's disease (BD) and to investigate whether disease activity changes in the presence of FM in female patients with BD. Patients and methods This cross-sectional study included 72 female patients with BD (mean age 39.7±10.5 years; range, 22 to 74 years) between June 2018 and February 2019. The frequency of FM was evaluated according to the American College of Rheumatology alternative criteria. Active clinical features and BD activity were evaluated with the Behçet's disease activity form (BDCAF). Results The prevalence of FM was 29.2% in the BD patients. BD clinical activity index, patients' perceptions of disease activity and clinicians' overall perceptions of disease activity scores were significantly higher in BD patients with FM (p=0.003, p<0.001 and p=0.025, respectively). The active clinical features of BD were not different between the groups except for genital ulcer. The prevalence of active genital ulcers was higher in BD patients with FM than in BD patients without FM (38.1% vs. 13.7%, respectively). Conclusion Disease activity is higher in female BD patients with FM than those without FM. High disease activity in female BD patients with FM may be associated with the presence of genital ulcers.
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Affiliation(s)
- Koray Ayar
- Department of Internal Medicine, Division of Rheumatology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Burcu Metİn Ökmen
- Department of Physical Therapy and Rehabilitation, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
| | - Lale Altan
- Department of Physical Therapy and Rehabilitation, Uludağ University Medical Faculty, Bursa, Turkey
| | - Esra KÖsegİl ÖztÜrk
- Department of Physical Therapy and Rehabilitation, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
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On A. Romatolojik hastalıklarda fibromiyaljinin payı. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.648902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Characteristics of Behcet's Disease in the American Southwest. Semin Arthritis Rheum 2019; 49:296-302. [DOI: 10.1016/j.semarthrit.2019.03.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/23/2019] [Accepted: 03/04/2019] [Indexed: 11/23/2022]
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Mumcu G, Direskeneli H. Triggering agents and microbiome as environmental factors on Behçet's syndrome. Intern Emerg Med 2019; 14:653-660. [PMID: 30523495 DOI: 10.1007/s11739-018-2000-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 11/29/2018] [Indexed: 12/13/2022]
Abstract
Environmental and other triggering factors are suggested to cause the onset and the clinical relapses of Behçet's syndrome (BS), a multi-systemic inflammatory disorder. In this review, environmental factors are discussed according to their interactions with etiopathogenesis, immune response and disease activity. Stress is a common self-triggering factor for most BS patients. Stimuli such as some foods can activate oral ulcers, and may be linked to the histamine content of the food. Oral/skin trauma and menstruation associated with hormonal factors aggravate, whereas allergy/atopy seem to alleviate the symptoms of BS. Infections are associated with BS, and microbial stimuli can activate inflammation in mucosal surfaces with increased Th1/Th17 responses. Fecal and oral microbiome patterns change in diversity and composition in BS. Better oral hygiene applications and anti-microbial interventions might be helpful to suppress oral ulcers in BS.
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Affiliation(s)
- Gonca Mumcu
- Department of Health Management, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Haner Direskeneli
- Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.
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Coloma JL, Martínez‐Zamora M, Collado A, Gràcia M, Rius M, Quintas L, Carmona F. Prevalence of fibromyalgia among women with deep infiltrating endometriosis. Int J Gynaecol Obstet 2019; 146:157-163. [DOI: 10.1002/ijgo.12822] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 01/21/2019] [Accepted: 04/10/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Jose Luis Coloma
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Maria‐Angeles Martínez‐Zamora
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Faculty of MedicineUniversity of Barcelona Barcelona Spain
| | - Antonio Collado
- Service of RheumatologyInstitut Clínic d'Especialitats Mèdiques i QuirúrgiquesHospital Clínic of Barcelona Barcelona Spain
| | - Meritxell Gràcia
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Mariona Rius
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Lara Quintas
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
| | - Francisco Carmona
- Department of GynecologyInstitut Clínic of Gynecology, Obstetrics and NeonatologyHospital Clínic of Barcelona Barcelona Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) Barcelona Spain
- Faculty of MedicineUniversity of Barcelona Barcelona Spain
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El-Rabbat M. S, Mahmoud NK, Gheita TA. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life. ACTA ACUST UNITED AC 2018; 14:285-289. [DOI: 10.1016/j.reuma.2017.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/23/2017] [Accepted: 02/26/2017] [Indexed: 01/09/2023]
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10
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Fibromyalgia Syndrome and Vitiligo: A Novel Association. Arch Rheumatol 2017; 33:174-180. [PMID: 30207563 DOI: 10.5606/archrheumatol.2018.6524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 07/06/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to assess the relationship between fibromyalgia syndrome (FMS) and vitiligo in Iraqi patients and evaluate the predictors of this relationship, if present. Patients and methods The case-control study included 100 Iraqi patients (46 males, 54 females; mean age 30.4±14 years; range 15 to 65 years) with vitiligo and 200 age- and sex-matched healthy controls (74 males, 126 females; mean age 30.3±9.4 years; range 15 to 62 years). Baseline characteristics of patients and controls were recorded. The 2012 Canadian Guidelines criteria were used for the diagnosis of FMS and applied to all patients and controls. Results Prevalence of FMS in vitiligo patients and controls was 12% and 7%, respectively (p=0.15, odds ratio=1.8, 95% confidence interval=0.8-4.08). FMS symptoms in vitiligo patients were fatigue (46%), diffuse body pain (34%), sleep disturbance (33%), cognitive dysfunction (30%), and mood disorders (23%), while visceral involvements were central nervous system (52%), skin (35%), gastrointestinal tract (32%), cardiovascular system- respiratory system (16%), genitourinary tract (8%), and ear nose throat (7%). Of vitiligo patients, FMS was significantly more common among females (22.2%) compared to none among males (0%) (p<0.05). Prevalence of FMS was restricted to female sex only and a significantly higher prevalence rate of FMS was found among female vitiligo patients (22.2%) compared to controls (9.5%). Receiving phototherapy significantly increased the risk of having FMS by 5 times compared to female patients not receiving phototherapy. Use of any steroid reduced the risk of having FMS by 2.5 times (inverse of odds ratio=0.4) among females patients (p>0/05). No significant association was found between FMS in vitiligo patients and age, disease duration, type of vitiligo, use of any immunosuppressant and body mass index (p>0.05). Conclusion Fibromyalgia syndrome was more prevalent in vitiligo patients compared to controls, which was clinically important but statistically not significant. There was a significant association between FMS in vitiligo patients and female sex, severe form of vitiligo, and receiving phototherapy. This may suggest that early diagnosis of FMS in vitiligo patients may help in early treatment and subsequently improve patients' quality of life.
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The frequency and effect of fibromyalgia in patients with Behçet's disease. Turk J Phys Med Rehabil 2017; 63:160-164. [PMID: 31453445 DOI: 10.5606/tftrd.2017.291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 06/22/2016] [Indexed: 01/29/2023] Open
Abstract
Objectives This study aims to investigate the scores of depression, anxiety, sleep and quality of life (QoL), to identify the prevalence of fibromyalgia (FM) in Behçet's disease (BD), and to evaluate whether there is a difference between BD patients with and without FM in these scores. Patients and methods Between March 2008 and January 2009, 97 patients with BD and 95 age- and sex-matched healthy controls were included in the study. The patients with BD were divided into two groups according to the presence or absence of FM. All participants were evaluated by the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), and Medical Outcomes Study Short Form-36 (SF-36). Results Compared to the controls, FM prevalence was higher (19.6% vs 3.2%) with increased BDI and BAI scores, while the subscores of SF-36 including physical function, physical role, pain, general health, social function, and emotional role decreased in BD patients (for all p<0.001). All BD patients with FM were females (n=19), while only 46% of BD patients without FM were females (n=36) (p<0.001). In BD patients with FM, compared to female BD patients without FM, the mean age (p=0.017), disease duration (p=0.028), and BDI scores (p=0.017) were significantly higher, while the PSQI scores (p=0.001) and SF-36 subscores, except general health (p=0.114), were significantly lower (for all p<0.05). Conclusion Our study results suggest that patients with BD have an increased severity of depression and anxiety, higher frequency of FM, and worsened QoL than healthy individuals. In addition, the presence of FM seems to be related with female sex, longer disease duration, older age, depression, sleep disturbance, and poor QoL in BD patients.
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Coexistence of familial Mediterranean fever and Behçet's disease: a case report. Turk J Phys Med Rehabil 2017; 63:174-177. [PMID: 31453447 DOI: 10.5606/tftrd.2017.72681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/17/2015] [Indexed: 11/21/2022] Open
Abstract
Behçet's disease (BD) is a chronic, multi-systemic vasculitis, characterized by a triad of recurrent aphthous stomatitis, genital aphthae, and uveitis. It is common in the Eastern Mediterranean, Middle East, and Eastern Asian countries. Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder, which is common seen in the Turkish, Armenian, Arabic, and Sephardic Jewish populations. It is characterized by recurrent episodes of fever, peritonitis, pleuritis, arthritis, and erysipelas-like skin lesions. Behçet's disease and FMF have common clinical features and geographic distribution. Herein, we present a 19-year-old female patient with coexistence of FMF and BD in the light of literature data.
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Jobanputra C, Richey RH, Nair J, Moots RJ, Goebel A. Fibromyalgia in Behçet's disease: a narrative review. Br J Pain 2017; 11:97-101. [PMID: 28491302 PMCID: PMC5405975 DOI: 10.1177/2049463717701393] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Fibromyalgia is characterised by chronic widespread pain and tenderness. It has often been reported to occur concomitantly with chronic rheumatological conditions. Behçet's disease is a chronic relapsing, multisystem, autoinflammatory disease. There is only limited understanding of a potential relationship between fibromyalgia and Behçet's disease. AIM Given the potential detrimental influence of pain on the outcome of chronic disease, the aim of this narrative review is to gain an understanding of the incidence and presentation of fibromyalgia in Behçet's disease. METHODS Electronic databases Scopus, Medline, PubMed and UpToDate were searched. RESULTS A total of 269 studies were identified, and limitations and exclusion/inclusion criteria were applied to ensure accurate and comparable selection of studies; four studies were selected. All cases were assessed for the presence of fibromyalgia according to the 1990 or 2010 diagnostic criteria of the American College of Rheumatology, with Behçet's disease diagnosed according to the International Study Group (ISG) for Behçet's disease criteria. A higher prevalence of fibromyalgia (5.7-37.1%) was reported in Behçet's disease compared to that of the general population (2.9-4.7%). DISCUSSION While an increased prevalence of fibromyalgia was found in patients with Behçet's disease, this needs to be considered within the context of limited available evidence. The potential impact of these conditions on the disease activity of each other is not clear and may require a prospective study. CONCLUSION Fibromyalgia appears to be more prevalent in those with Behçet's disease than would be expected in the overall population. Significance: This review provides some evidence that fibromyalgia is more prevalent in those with Behçet's disease. To ensure appropriate patient treatment choices, it is important that both conditions are diagnosed where they co-exist.
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Affiliation(s)
| | | | - Jagdish Nair
- Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Robert J Moots
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Andreas Goebel
- The Walton Centre NHS Foundation Trust, Liverpool, UK
- Pain Research Institute, University of Liverpool, Liverpool, UK
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Heidari F, Afshari M, Moosazadeh M. Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis. Rheumatol Int 2017; 37:1527-1539. [DOI: 10.1007/s00296-017-3725-2] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
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15
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Kaya Erdogan H, Sas S, Acer E, Bulur I, Altunay IK, Erdem HR. Cutaneous findings in fibromyalgia syndrome and their effect on quality of life. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2016.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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16
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Ilhan B, Can M, Alibaz-Oner F, Yilmaz-Oner S, Polat-Korkmaz O, Ozen G, Mumcu G, Maradit Kremers H, Direskeneli H. Fatigue in patients with Behçet's syndrome: relationship with quality of life, depression, anxiety, disability and disease activity. Int J Rheum Dis 2016; 21:2139-2145. [DOI: 10.1111/1756-185x.12839] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Birkan Ilhan
- Department of Internal Medicine; School of Medicine; Marmara University; Istanbul Turkey
| | - Meryem Can
- Department of Rheumatology; Fatih Sultan Mehmet Education and Research Hospital; Istanbul Turkey
| | - Fatma Alibaz-Oner
- Department of Rheumatology; School of Medicine; Marmara University; Istanbul Turkey
| | - Sibel Yilmaz-Oner
- Department of Rheumatology; School of Medicine; Marmara University; Istanbul Turkey
| | - Ozge Polat-Korkmaz
- Department of Internal Medicine; School of Medicine; Marmara University; Istanbul Turkey
| | - Gulsen Ozen
- Department of Rheumatology; School of Medicine; Marmara University; Istanbul Turkey
| | - Gonca Mumcu
- Faculty of Health Sciences; Marmara University; Istanbul Turkey
| | | | - Haner Direskeneli
- Department of Rheumatology; School of Medicine; Marmara University; Istanbul Turkey
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Coexistence of Familial Mediterranean Fever With Ankylosing Spondylitis and Sjogren's Syndrome: A Rare Occurrence. Arch Rheumatol 2015; 31:87-90. [PMID: 29900978 DOI: 10.5606/archrheumatol.2016.5671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 09/30/2015] [Indexed: 11/21/2022] Open
Abstract
Familial Mediterranean fever is an autosomal recessive disease characterized by recurrent episodes of fever, peritonitis, synovitis, pleuritis, and erysipelas-like skin lesions. Sjogren's syndrome is a chronic autoimmune disorder characterized by dry eyes, dry mouth, and musculoskeletal involvement. Ankylosing spondylitis is an autoinflammatory rheumatic disease which affects mainly the axial skeleton. To our knowledge, coexistence of familial Mediterranean fever with ankylosing spondylitis and Sjogren's syndrome has not been reported previously in the literature. In this article, we report an unusual case of three autoinflammatory diseases in one patient.
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Choi HJ, Han JY, Seo MR, Ryu HJ, Baek HJ. Fibromyalgia with chronic rheumatic diseases in South Korea: a comparison of clinical and American College of Rheumatology criteria. Int J Rheum Dis 2015; 20:1922-1926. [PMID: 25990794 DOI: 10.1111/1756-185x.12678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To describe the prevalence and characteristics of fibromyalgia (FM) in patients with underlying rheumatic disease, and to compare it by three different measures. METHODS We studied 546 patients with chronic rheumatic diseases who attended our rheumatology clinic. If patients answered all of a screening questionnaire with yes, then we considered patients to be having widespread pain as assessed by the fibromyalgia impact questionnaire (FIQ), widespread pain index (WPI), and symptom severity (SS). A physician administered the tender point (TP) exam and clinician's judgment of FM. We collected demographics, clinical and laboratory features. RESULTS One hundred and sixty-four (30.0%) patients among 546 cases had a further exam. The male-to-female count was 25 : 139. The mean age was 49.7 years, disease duration 3.7 years, TP counts 4.2, FIQ score 47.0 and WPI with SS score was 11.1. We classified 17 patients (10.4%) with concomitant FM with widespread pain by tender point exam, 56 patients (34.2%) by WPI with SS, and 36 patients (22.0%) by a clinician's judgment. A total of 70.6% (n = 12) of those classified as FM by 1990 American College of Rheumatology (ACR) criteria wee categorized as FM by clinician's judgment, while 33.3% by clinician's judgment were classified by 1990 ACR criteria. CONCLUSIONS We found a 10.4~34.2% prevalence of concomitant FM in the patients with chronic widespread pain. The 1990 ACR criteria were the most restrictive except for SLE. Although The 2010 ACR criteria had a wide spectrum, it can be used for FM diagnosis even in the patient with underlying rheumatic diseases.
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Affiliation(s)
- Hyo Jin Choi
- Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Jung Yoon Han
- Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Mi Ryoung Seo
- Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Hee Jung Ryu
- Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Han Joo Baek
- Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
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Haliloglu S, Carlioglu A, Akdeniz D, Karaaslan Y, Kosar A. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity. Rheumatol Int 2014; 34:1275-80. [PMID: 24589726 DOI: 10.1007/s00296-014-2972-8] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 02/19/2014] [Indexed: 01/09/2023]
Abstract
Fibromyalgia (FM) is a syndrome characterized by chronic widespread pain and the presence of specific tender points. The prevalence of FM has been estimated at 2-7 % of the general global population. The presence of FM in several rheumatic diseases with a structural pathology has been reported as 11-30 %. The objectives of this study were to determine the prevalence of FM and to evaluate the possible relationship between FM existence and disease activity among rheumatic diseases. The study group included 835 patients--197 rheumatoid arthritis (RA), 67 systemic lupus erythematosus (SLE), 119 ankylosing spondylitis (AS), 238 osteoarthritis (OA), 14 familial Mediterranean fever (FMF), 53 Behçet's disease (BD), 71 gout, 25 Sjögren's syndrome (SS), 20 vasculitis, 29 polymyalgia rheumatica (PMR), and two polymyositis (PM)--with or without FM. Recorded information included age, gender, laboratory parameters, presence of fatigue, and disease activity indexes. The prevalence of FM in patients with rheumatologic diseases was found to be 6.6 % for RA, 13.4 % for SLE, 12.6 % for AS, 10.1 % for OA, 5.7 % for BD, 7.1 % for FMF, 12 % for SS, 25 % for vasculitis, 1.4 % for gout, and 6.9 % for PMR. One out of two patients with PM was diagnosed with FM. Some rheumatologic cases (AS, OA) with FM were observed mostly in female patients (p = 0.000). Also, there were significant correlations between disease activity indexes and Fibromyalgia Impact Questionnaire scores for most rheumatologic patients (RA, AS, OA, and BD) (p < 0.05; respectively, r = 0.6, 0.95, 0.887, and 1). Concomitant FM is a common clinical problem in rheumatologic diseases, and its recognition is important for the optimal management of these diseases. Increased pain, physical limitations, and fatigue may be interpreted as increased activity of these diseases, and a common treatment option is the prescription of higher doses of biologic agents or corticosteroids. Considerations of the FM component in the management of rheumatologic diseases increase the likelihood of the success of the treatment.
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Affiliation(s)
- Sema Haliloglu
- Department of Physical Medicine and Rehabilitation, Erzurum Regional Research and Training Hospital, 25240, Erzurum, Turkey,
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Hatemi G, Merkel PA, Hamuryudan V, Boers M, Direskeneli H, Aydin SZ, Yazici H. Outcome measures used in clinical trials for Behçet syndrome: a systematic review. J Rheumatol 2014; 41:599-612. [PMID: 24488418 DOI: 10.3899/jrheum.131249] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Behçet syndrome (BS) is a multisystem vasculitis that is most active during young adulthood, causing serious disability and significant impairment in quality of life. Differences in the disease course, severity, and organ involvement between patients, depending on the age at presentation and sex, makes it impossible to determine a single management strategy. The diversity and variability in the outcome measures used in clinical trials in BS makes it difficult to compare the results or inform physicians about the best management strategy for individual patients. There is a large unmet need to determine or develop validated outcome measures for use in clinical trials in BS that are acceptable to researchers and regulatory agencies. We conducted a systematic review to describe the outcomes and outcome measures that have been used in clinical trials in BS. This review revealed the diversity and variability in the outcomes and outcome measures and the lack of standard definitions for most outcomes and rarity of validated outcome tools for disease assessment in BS. This systematic literature review will identify domains and candidate instruments for use in a Delphi exercise, the next step in the development of a core set of outcome measures that are properly validated and widely accepted by the collaboration of researchers from many different regions of the world and from different specialties, including rheumatology, ophthalmology, dermatology, gastroenterology, and neurology.
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Affiliation(s)
- Gulen Hatemi
- From the Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey; Division of Rheumatology and Department of Epidemiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Clinical Epidemiology, VU University Medical Center, Amsterdam, The Netherlands; Department of Rheumatology, Marmara University School of Medicine, Istanbul; Department of Rheumatology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
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Giacomelli C, Talarico R, Bombardieri S, Bazzichi L. The interaction between autoimmune diseases and fibromyalgia: risk, disease course and management. Expert Rev Clin Immunol 2014; 9:1069-76. [DOI: 10.1586/1744666x.2013.849440] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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