新冠后综合征的新临床表型:纤维肌痛和关节活动过度症

New Clinical Phenotype of the Post-Covid Syndrome: Fibromyalgia and Joint Hypermobility Condition.

作者信息

Gavrilova Natalia, Soprun Lidiia, Lukashenko Maria, Ryabkova Varvara, Fedotkina Tamara V, Churilov Leonid P, Shoenfeld Yehuda

机构信息

Laboratory of the Mosaic of Autoimmunity, Saint Petersburg State University, 199034 Saint Petersburg, Russia.

Saint Petersburg Research Institute of Phthisiopulmonology, 191036 Saint Petersburg, Russia.

出版信息

Pathophysiology. 2022 Jan 19;29(1):24-29. doi: 10.3390/pathophysiology29010003.

Abstract

Fibromyalgia can be defined as a chronic pain condition, affecting the musculoskeletal system, etiology and pathophysiology of which is sufficiently understudied. Despite the fact that many authors consider this entity to be a manifestation of central sensitization, and not an autoimmune disease, the high prevalence of fibromyalgia in patients with post-COVID-19 conditions requires taking a fresh look at the causes of the disease development. During the patient examination, the authors identified a combination of symptoms that occurs so often, that they can be carefully described as a clinical pattern. These manifestations include young age, female gender, joint hypermobility, the onset of pain after COVID-19, physical traumatization of one particular tendon and the development of the fibromyalgia pain syndrome during the next several weeks. As well as an increase in the titer of antinuclear antibodies and some other systemic inflammation factors. It can be assumed with great caution that local damage to the connective tissue in patients with joint hypermobility, having COVID-19 as a trigger factor can lead to the development of fibromyalgia syndrome. This article presents three clinical cases that illustrated this hypothesis.

摘要

纤维肌痛可被定义为一种慢性疼痛病症,影响肌肉骨骼系统,其病因和病理生理学尚未得到充分研究。尽管许多作者认为该病症是中枢敏化的表现,而非自身免疫性疾病,但新冠后病症患者中纤维肌痛的高患病率需要重新审视该疾病发展的原因。在对患者进行检查时,作者发现了一组经常出现的症状组合,这些症状可以被仔细描述为一种临床模式。这些表现包括年轻、女性、关节活动过度、新冠感染后疼痛发作、某一特定肌腱的身体创伤以及在接下来几周内纤维肌痛疼痛综合征的发展。以及抗核抗体滴度和其他一些全身炎症因子的增加。可以非常谨慎地推测,以新冠感染为触发因素,关节活动过度的患者结缔组织的局部损伤可能导致纤维肌痛综合征的发展。本文介绍了三个临床病例来说明这一假设。

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