Ahmad Jowairiyya, Tagoe Clement E
Department of Geriatrics, Albert Einstein College of Medicine, Bronx, NY, USA,
Clin Rheumatol. 2014 Jul;33(7):885-91. doi: 10.1007/s10067-014-2490-9. Epub 2014 Jan 18.
Fibromyalgia and chronic widespread pain syndromes are among the commonest diseases seen in rheumatology practice. Despite advances in the management of these conditions, they remain significant causes of morbidity and disability. Autoimmune thyroid disease is the most prevalent autoimmune disorder, affecting about 10 % of the population, and is a recognized cause of fibromyalgia and chronic widespread pain. Recent reports are shedding light on the mechanisms of pain generation in autoimmune thyroid disease-associated pain syndromes including the role of inflammatory mediators, small-fiber polyneuropathy, and central sensitization. The gradual elucidation of these pain pathways is allowing the rational use of pharmacotherapy in the management of chronic widespread pain in autoimmune thyroid disease. This review looks at the current understanding of the prevalence of pain syndromes in autoimmune thyroid disease, their likely causes, present appreciation of the pathogenesis of chronic widespread pain, and how our knowledge can be used to find lasting and effective treatments for the pain syndromes associated with autoimmune thyroid disease.
纤维肌痛和慢性广泛性疼痛综合征是风湿病科临床中最常见的疾病之一。尽管在这些病症的管理方面取得了进展，但它们仍然是发病和致残的重要原因。自身免疫性甲状腺疾病是最常见的自身免疫性疾病，约影响10%的人口，是公认的纤维肌痛和慢性广泛性疼痛的病因。最近的报告正在揭示自身免疫性甲状腺疾病相关疼痛综合征中疼痛产生的机制，包括炎症介质、小纤维多发性神经病和中枢敏化的作用。这些疼痛途径的逐步阐明使得在自身免疫性甲状腺疾病慢性广泛性疼痛的管理中合理使用药物治疗成为可能。本综述探讨了目前对自身免疫性甲状腺疾病中疼痛综合征患病率的认识、其可能的病因、对慢性广泛性疼痛发病机制的当前理解，以及我们如何利用现有知识找到针对与自身免疫性甲状腺疾病相关疼痛综合征的持久有效治疗方法。
