THU0345
SIMILARITIES BETWEEN FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME: A SINGLE DISEASE?
J. Rivera 1,*A. Collado 2J. Alegre 3J. Blanch 4J. Vidal 5A. Arias 2J. Carbonel 4 and FSGCDB Group (Fibromyalgia and SFC Spanish Genetic and Clinical Data Bank). Foundation FF.
1Unidad de Reumatología, IPR. Hospital Gregorio Marañón, Madrid, 2Fibromyalgia Unit, Hospital Clínic of Barcelona, 3Chronic Fatigue Department , Hospital Valle Hebron, 4Fibromyalgia Unit , Hospital del Mar, Barcelona, 5Rheumatology Service, Hospital General of Guadalajara, Guadalajara, Spain
Background: Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are considered two different entities. The clinical criteria used for the diagnosis do not permit to understand the true relationship between them, although they share many similar demographic and clinical aspects (1). For example: it is known that FM is a disease with extensive involvement of the nociceptive system with a significant number of tender points. However, recent studies have also shown similar findings in CFS (2).
Objectives: The aim of our study is to analyze the clinical differences between these two entities in a large sample of patients.
Methods: A total of 2007 patients and 398 healthy family controls were studied in different specialized units in FM and / or CFS in Spain. 1374 patients met the 1990 ACR criteria for the diagnosis of FM (women 97%, mean age 49,3 ± 10,08 years), 396 patients fulfilled the Fukuda criteria for CFS (women 84%, mean age 45,44 ± 11,85 years) and 241 patients met both sets of criteria (women 92%, mean age 47,23 ± 10,65 years). All patients and controls were studied for demographic variables, personal and family history, clinical symptoms, comorbidities, health status and standardized test sensitivities.
Results: Results: The main findings are show in the table.
Variable |
FM (%) |
SFC(%) |
FM+SFC(%) |
Control(%) |
|
Family history of Fibromyalgia |
15,4 |
18,9 |
22,4 |
-- |
|
Personal history of previous psychopathology |
23,0 |
42,2* |
37,3* |
5,8* |
|
Age of onset of principal symptom |
37,1 |
36,0 |
34,6 |
-- |
|
Chronic pain evolution time (months) |
129,3 |
69,7* |
136,8 |
-- |
|
Fatigue evolution time (months) |
106,1 |
104,7 |
129,6 |
-- |
|
Current level of pain (VAS 1-10 cm) |
7,2 |
6,4 |
7,5 |
-- |
|
Extension of pain (number of pain areas) |
15,1 |
11,9 |
16,0 |
-- |
|
Number of tender points (0-18) |
14,9 |
3,4* |
14,0 |
0,4* |
|
Number of comorbidities |
1,6 |
1,9* |
2,2* |
-- |
|
Number of psychiatric comorbidities |
0,4 |
0,5* |
0,6* |
-- |
|
Autonomous dysfunction |
5,6 |
6,3* |
6,5* |
-- |
|
Immunological symptoms |
3,2 |
3,6* |
4,0* |
-- |
|
Major depression / dysthymia |
0,2 |
0,3* |
0,35* |
-- |
|
Unrefreshing sleep |
82,0% |
96,2% |
87,1% |
-- |
|
Pittsburg Sleep Quality Index |
13,6 |
12,4 |
14,5 |
6,1* |
|
SF-36 (Quality of Life) Physical Dimension |
28,2 |
27,2 |
26,1 |
48,2* |
|
SF-36 (Quality of Life) Mental Dimension |
36,6 |
38,2 |
34,6 |
46,3* |
* p< 0.001
Conclusions: The findings suggest a single process with a different stage of evolution from lower to higher severity in FM, SFC and FM-SFC, respectively. In CFS patients without FM criteria, there is a high proportion of men and have more comorbid psychopathology. Also in these patients, there are a great number of neurovegetative or immunological symptoms.There were no significant differences in the remaining variables studied, with the exception of tender points which were used as a classification criterion.
References:
1. Dedra Buchwald. Rheum Dis Clin North Am. 1996 May;22(2):219-43
2. Meeus M, Nijs J, Huybrechts S, Truijen S. Clin Rheumatol. 2010 Apr;29(4):393-8
Disclosure of Interest: None Declared