Literature DB >> 19004039

Fibromyalgia, systemic lupus erythematosus (SLE), and evaluation of SLE activity.

Frederick Wolfe1, Michelle Petri, Graciela S Alarcón, John Goldman, Eliza F Chakravarty, Robert S Katz, Elizabeth W Karlson.   

Abstract

OBJECTIVE: To determine if fibromyalgia (FM) or fibromyalgia-ness (the tendency to respond to illness and psychosocial stress with fatigue, widespread pain, general increase in symptoms, and similar factors) is increased in patients with compared to those without systemic lupus erythematosus (SLE); to determine whether FM or fibromyalgia-ness biases the SLE Activity Questionnaire (SLAQ); and to determine if the SLAQ is overly sensitive to FM symptoms.
METHODS: We developed a 16-item SLE Symptom Scale (SLESS) modeled on the SLAQ and used that scale to investigate the relation between SLE symptoms and fibromyalgia-ness in 23,321 patients with rheumatic disease. FM was diagnosed by survey FM criteria, and fibromyalgia-ness was measured using the Symptom Intensity (SI) Scale. As comparison groups, we combined patients with rheumatoid arthritis and noninflammatory rheumatic disorders into an "arthritis" group and also utilized a physician-diagnosed group of patients with FM.
RESULTS: FM was identified in 22.1% of SLE and 17.0% of those with arthritis. The SI scale was minimally increased in SLE. The correlation between SLAQ and SLESS was 0.738. SLESS/SLAQ scale items (Raynaud's phenomenon, rash, fever, easy bruising, hair loss) were significantly more associated with SLE than FM, while the reverse was true for headache, abdominal pain, paresthesias/stroke, fatigue, cognitive problems, and muscle pain or weakness. There was no evidence of disproportionate symptom-reporting associated with fibromyalgia-ness. Self-reported SLE was associated with an increased prevalence of FM that was unconfirmed by physicians, compared to SLE confirmed by physicians.
CONCLUSION: The prevalence of FM in SLE is minimally increased compared with its prevalence in patients with arthritis. Fibromyalgia-ness does not bias the SLESS and should not bias SLE assessments, including the SLAQ.

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Year:  2009        PMID: 19004039      PMCID: PMC2944223          DOI: 10.3899/jrheum.080212

Source DB:  PubMed          Journal:  J Rheumatol        ISSN: 0315-162X            Impact factor:   4.666


  26 in total

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2.  Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

Authors:  M C Hochberg
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3.  More pain, more tender points: is fibromyalgia just one end of a continuous spectrum?

Authors:  P Croft; J Burt; J Schollum; E Thomas; G Macfarlane; A Silman
Journal:  Ann Rheum Dis       Date:  1996-07       Impact factor: 19.103

4.  Fibromyalgia is a major contributor to quality of life in lupus.

Authors:  D D Gladman; M B Urowitz; J Gough; A MacKinnon
Journal:  J Rheumatol       Date:  1997-11       Impact factor: 4.666

5.  The relation between tender points and fibromyalgia symptom variables: evidence that fibromyalgia is not a discrete disorder in the clinic.

Authors:  F Wolfe
Journal:  Ann Rheum Dis       Date:  1997-04       Impact factor: 19.103

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Authors:  Somchai Akkasilpa; Daniel Goldman; Laurence S Magder; Michelle Petri
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7.  Fibromyalgia diagnosis: a comparison of clinical, survey, and American College of Rheumatology criteria.

Authors:  Robert S Katz; Frederick Wolfe; Kaleb Michaud
Journal:  Arthritis Rheum       Date:  2006-01

8.  Fibromyalgia in Indian patients with SLE.

Authors:  R Handa; P Aggarwal; J P Wali; N Wig; S N Dwivedi
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Journal:  Arthritis Rheum       Date:  1990-02

10.  Population study of tender point counts and pain as evidence of fibromyalgia.

Authors:  P Croft; J Schollum; A Silman
Journal:  BMJ       Date:  1994-09-17
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6.  Reduction in movement-evoked pain and fatigue during initial 30-minute transcutaneous electrical nerve stimulation treatment predicts transcutaneous electrical nerve stimulation responders in women with fibromyalgia.

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