Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
Int J Rheum Dis. 2017 Dec;20(12):1922-1926. doi: 10.1111/1756-185X.12678. Epub 2015 May 20.
To describe the prevalence and characteristics of fibromyalgia (FM) in patients with underlying rheumatic disease, and to compare it by three different measures.
We studied 546 patients with chronic rheumatic diseases who attended our rheumatology clinic. If patients answered all of a screening questionnaire with yes, then we considered patients to be having widespread pain as assessed by the fibromyalgia impact questionnaire (FIQ), widespread pain index (WPI), and symptom severity (SS). A physician administered the tender point (TP) exam and clinician's judgment of FM. We collected demographics, clinical and laboratory features.
One hundred and sixty-four (30.0%) patients among 546 cases had a further exam. The male-to-female count was 25 : 139. The mean age was 49.7 years, disease duration 3.7 years, TP counts 4.2, FIQ score 47.0 and WPI with SS score was 11.1. We classified 17 patients (10.4%) with concomitant FM with widespread pain by tender point exam, 56 patients (34.2%) by WPI with SS, and 36 patients (22.0%) by a clinician's judgment. A total of 70.6% (n = 12) of those classified as FM by 1990 American College of Rheumatology (ACR) criteria wee categorized as FM by clinician's judgment, while 33.3% by clinician's judgment were classified by 1990 ACR criteria.
We found a 10.4~34.2% prevalence of concomitant FM in the patients with chronic widespread pain. The 1990 ACR criteria were the most restrictive except for SLE. Although The 2010 ACR criteria had a wide spectrum, it can be used for FM diagnosis even in the patient with underlying rheumatic diseases.
描述潜在风湿性疾病患者中纤维肌痛（FM）的患病率和特征，并通过三种不同的方法进行比较。
我们研究了 546 名在我们风湿病诊所就诊的慢性风湿性疾病患者。如果患者对筛查问卷的所有问题均回答“是”，则我们认为患者患有广泛性疼痛，评估方法为纤维肌痛影响问卷（FIQ）、广泛性疼痛指数（WPI）和症状严重程度（SS）。医生进行压痛点（TP）检查和临床医生对 FM 的判断。我们收集了人口统计学、临床和实验室特征。
在 546 例病例中，有 164 例（30.0%）进行了进一步检查。男女比例为 25：139。平均年龄为 49.7 岁，病程 3.7 年，TP 计数 4.2，FIQ 评分为 47.0，WPI 伴 SS 评分为 11.1。我们通过压痛检查将 17 名（10.4%）伴有广泛疼痛的患者分类为伴有 FM，56 名（34.2%）通过 WPI 伴 SS，36 名（22.0%）通过临床医生的判断。根据 1990 年美国风湿病学会（ACR）标准分类为 FM 的患者中，有 70.6%（n=12）通过临床医生的判断也被归类为 FM，而通过临床医生判断的患者中有 33.3%被归类为 1990 年 ACR 标准。
我们发现慢性广泛性疼痛患者中伴有 FM 的患病率为 10.4%~34.2%。除了系统性红斑狼疮（SLE）外，1990 年 ACR 标准是最具限制性的。虽然 2010 年 ACR 标准具有广泛的谱，但即使在患有潜在风湿性疾病的患者中，也可以使用该标准进行 FM 诊断。
