Al Samsam Hind H, Fazal Fahad, Al Nokhatha Shamma, AlJaberi Asma, Adam Abdelrahman, Huwaijah Said, Bekhit Wael
Internal Medicine, Mediclinic Al Ain Hospital, Al Ain, ARE.
Rheumatology, Mediclinic Al Ain Hospital, Al Ain, ARE.
Cureus. 2024 Aug 30;16(8):e68181. doi: 10.7759/cureus.68181. eCollection 2024 Aug.
Three young female patients with a history of generalized body pain were diagnosed with fibromyalgia. They visited several specialities which related patients' symptoms to their previous diagnosis of fibromyalgia and were treated symptomatically. These patients developed a multitude of clinical features including fractures, hypertension, abnormal weight gain, proximal myopathic pain and bruising. They were seen by rheumatologists whose assessment was that their clinical features were not entirely due to fibromyalgia and suspected that patients have a possible underlying endocrine cause. Patients were referred to an endocrinologist for further tests with suspicion of Cushing's syndrome. Laboratory tests and imaging confirmed a diagnosis of Cushing's syndrome. Two of them had adrenal adenoma and one had iatrogenic corticosteroid use. These cases emphasize the need for thorough clinical evaluation for patients who are thought to have fibromyalgia. Fibromyalgia is a diagnosis of exclusion.
三名有全身疼痛病史的年轻女性患者被诊断为纤维肌痛。她们看了几个专科,医生将患者的症状与其先前诊断的纤维肌痛联系起来并进行了对症治疗。这些患者出现了多种临床特征,包括骨折、高血压、体重异常增加、近端肌病性疼痛和瘀伤。风湿科医生对她们进行了检查,评估认为她们的临床特征并不完全由纤维肌痛引起,并怀疑患者可能存在潜在的内分泌病因。因怀疑库欣综合征,患者被转诊至内分泌科进行进一步检查。实验室检查和影像学检查确诊为库欣综合征。其中两人患有肾上腺腺瘤,一人有医源性皮质类固醇使用史。这些病例强调了对疑似纤维肌痛患者进行全面临床评估的必要性。纤维肌痛是一种排除性诊断。