Department of Rheumatology, Merlin Park University Hospital, Galway, Ireland.
J Clin Gastroenterol. 2013 Jul;47(6):559-64. doi: 10.1097/MCG.0b013e31826f7ad7.
Subjects with HFE-related hereditary hemochromatosis (HH) may present with arthralgias, fatigue, and stiffness, yet little is known on the presence of fibromyalgia syndrome (FMS) in these subjects. We determined the prevalence of FMS in a cohort of subjects with HH and evaluated its relationship to subject demographics, disease status, and quality of life.
In a cross-sectional study we collected data on 395 consecutive subjects diagnosed with HH who were attending a tertiary referral Hepatology outpatient clinic at Galway University Hospital, Ireland (between October 2009 and June 2010). Subjects underwent a standard assessment including history, clinical examination, and functional assessments for pain and disability. Univariate logistic regression was applied to determine risk factors independently associated with prevalent FMS in these subjects.
Three hundred ninety-five subjects met the inclusion criteria. Mean age was 43 years (range, 21 to 59 y) and 260 (66%) were males. One hundred seventy (43%) of the subjects were diagnosed with FMS. Among those with fibromyalgia fatigue and ≥ 11 tender points were present in all of the subjects, widespread pain in 150 (88%), depression in 70 (41%), and arthralgia/joint stiffness in 70 (41%). In subjects with FMS 33% reported some functional impairment (HAQ-DI>0), with 10% reporting moderate-severe functional impairment (HAQ-DI ≥ 1.5).
This study reveals a high prevalence of FMS (43%) among subjects with HFE-related hemochromatosis. Prospective studies are needed to better understand the risk factors for FMS in such patients.
患有 HFE 相关遗传性血色素沉着症（HH）的患者可能会出现关节痛、疲劳和僵硬，但对于这些患者中纤维肌痛综合征（FMS）的存在知之甚少。我们确定了 HH 患者队列中 FMS 的患病率，并评估了其与患者人口统计学、疾病状况和生活质量的关系。
在一项横断面研究中，我们收集了 2009 年 10 月至 2010 年 6 月期间在爱尔兰戈尔韦大学医院三级转诊肝病门诊就诊的 395 例连续诊断为 HH 的患者的数据。患者接受了标准评估，包括病史、临床检查以及疼痛和残疾的功能评估。应用单变量逻辑回归确定与这些患者中普遍存在的 FMS 相关的独立危险因素。
395 名患者符合纳入标准。平均年龄为 43 岁（范围 21 至 59 岁），260 名（66%）为男性。170 名（43%）患者被诊断为 FMS。在患有纤维肌痛的患者中，所有患者均存在疲劳和≥11 个触痛点、150 例（88%）存在广泛疼痛、70 例（41%）存在抑郁、70 例（41%）存在关节痛/关节僵硬。在患有 FMS 的患者中，33%报告存在一定程度的功能障碍（HAQ-DI>0），10%报告存在中度至重度功能障碍（HAQ-DI≥1.5）。
本研究揭示了 HFE 相关遗传性血色素沉着症患者中 FMS 的高患病率（43%）。需要前瞻性研究来更好地了解此类患者中 FMS 的危险因素。
