Levine Todd D, Saperstein David S
Phoenix Neurological Associates, Ltd, 5090 N 40th Street, Suite #250, Phoenix, AZ, 85018, USA,
Clin Rheumatol. 2015 Mar;34(3):413-7. doi: 10.1007/s10067-014-2850-5. Epub 2014 Dec 24.
Fibromyalgia is a clinical syndrome that currently does not have any specific pathological finding to aid in diagnosis. Therefore, fibromyalgia is most likely a heterogeneous group of diseases with similar symptoms. Identifying and understanding the pathological basis of fibromyalgia will allow physicians to better categorize patients, increasing prospective treatment options, and improving potential therapeutic endeavors. Recent work has demonstrated that approximately 50% of patients diagnosed with fibromyalgia have damage to their small unmyelinated nerve fibers. A skin punch biopsy is a sensitive and specific diagnostic test for this damage as a reduction in nerve fiber density allows for the diagnosis of small fiber neuropathy. Small fiber neuropathy is a disease with symptoms similar to fibromyalgia, but it often has a definable etiology. Identifying small fiber neuropathy and its underlying cause in fibromyalgia patients provides them with a succinct diagnosis, increases treatment options, and facilitates more specific studies for future therapeutics.
纤维肌痛是一种临床综合征，目前没有任何特定的病理发现可辅助诊断。因此，纤维肌痛很可能是一组具有相似症状的异质性疾病。识别和理解纤维肌痛的病理基础将使医生能够更好地对患者进行分类，增加前瞻性治疗选择，并改善潜在的治疗方法。最近的研究表明，约50%被诊断为纤维肌痛的患者存在小的无髓神经纤维损伤。皮肤活检对这种损伤是一种敏感且特异的诊断测试，因为神经纤维密度降低可诊断为小纤维神经病变。小纤维神经病变是一种症状与纤维肌痛相似的疾病，但通常有明确的病因。在纤维肌痛患者中识别小纤维神经病变及其潜在病因可为他们提供简洁的诊断，增加治疗选择，并有助于未来治疗的更具体研究。
