By Dr Ananya Mandal, MD
Fibromyalgia has been commonly misdiagnosed in patients with Systemic Lupus Erythematosus (SLE) since the symptoms of both conditions may significantly overlap making diagnosis difficult.
What is fibromyalgia and who does it affect?
Fibromyalgia syndrome is a chronic and long term condition that has no cure. The condition affects muscles, tendons and ligaments and results in widespread pain, fatigue, headaches, irritable bowel syndrome, inability to get refreshing sleep, waking up tired and stiff and developing cognitive disturbances including lack of concentration and clumsiness, dizziness and myriads of other debilitating symptoms that make life difficult for patients.
There is in addition extreme sensitivity to pain. The condition is termed as a syndrome because it is a collection of symptoms rather than a specific symptom alone. Patients tend to be sensitive to changes in the weather, to bright lights, noise etc.
These symptoms have varying course of severity and come and go over time. There are periods of flare-ups followed by periods where symptoms are minimal.
About 10 million people are currently diagnosed with this disorder. Although 9 out of 10 people diagnosed are women, men also get this disorder. However fibromyalgia is not life-threatening and does not reduce life expectancy.
What is lupus?
Systemic Lupus Erythematosus (SLE) or lupus is a poorly understood condition that affects the immune system. It is most likely a complex autoimmune disease.
The immune system normally protects the body from microbes and foreign invasions by germs. Inb autoimmune diseases the immune system fails to recognize self from non-self and attacks the body’s own cells.
SLE may affect many parts of the body and may result in mild to severe and life threatening manifestations. Common symptoms of SLE include skin rash, fatigue and joint pain and swelling. SLE is also more common among women than in men.
Fibromyalgia and lupus
Due to the pain and fatigue as well as female gender preponderance, that commonly is seen in both fibromyalgia and SLE, diagnosis and detection is often a challenge. Fibromyalgia usually has clinical features that may lead to misinterpretation of lupus activity.
Studies have evaluated the prevalence of fibromyalgia syndrome in patients with systemic lupus erythematosus and have attempted to evaluate the clinical impact and relationship of fibromyalgia with SLE.
Results have showed that nearly a quarter of patients (22%) with SLE meet the American College of Rheumatology criteria for fibromyalgia including widespread pain, tender points, fatigue and non-refreshing sleep.
Patients who have both fibromyalgia as well as SLE also have increased frequency and severity of symptoms of fibromyalgia and are more likely to be severely debilitated and unable to perform daily activities.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)