AB0547 INVESTIGATION OF THE PRESENCE OF FIBROMYALGIA SYNDROME IN PATIENTS WITH SCLERODERMA
Authors: A. Ayan, H. Hekim, S. Y. Cetin
Journal: Annals of the Rheumatic Diseases (2020)

Background: As with other connective tissue diseases, fibromyalgia (FMS) syndrome is not uncommon in scleroderma. However, there is no clear information about it in the literature. According to 1990 ACR criteria, sensitive point evaluation was made in scleroderma and FMS frequency was reported as 18.6% in scleroderma patients. However, it is known that fibrosis creates difficulties in sensitive point determination. moreover, ACR 1990 criteria cannot be met in approximately 25% of fibromyalgia patients. Therefore, the frequency of fibromyalgia in scleroderma patients is unclear. In 1990, ACR announced new criteria in 2010 due to the low sensitivity of ACR criteria to FMS detection and not being used in the follow-up of the disease. In the new set of criteria, not the 18 sensitive point evaluations, but the Widespread Pain Index and Symptom Severity Scale are evaluated. Objectives: In this study, we planned to investigate the frequency of fibromyalgia in systemic sclerosis patients according to the new ACR criteria defined in 2010. Methods: 43 patients with diffuse systemic sclerosis with no known additional diseases were included in the study. Patients were evaluated with the new fibromyalgia diagnostic criteria set. Patients were evaluated with Fibromyalgia Impact Questionnaire (FIQ), Pain Location Score (PLS), Symptom Impact Questionnaire (SEA), Widespread Pain Index (WPI) and Symptom Severity Scale (SSS). Results: The mean age of the patients was 53.45 ± 12.87 years (39 women, 4 men). Mean values were FIQ: 46.05 ± 17.44, PLS:18.32 ± 9.87, SEA: 20.76 ± 11.31, WPI: 7.93 ± 5.87, SSS: 6.51 ± 3.41 respectively. According to these results, 62.8% (n: 27) FMS presence of SS patients was detected. Conclusion: In the literature, there are only a few studies evaluating the frequency of FMS in scleroderma patients. Malcarne et al. reported that 18.6% of 102 SSc patients met the 1990 classification criteria for FMS. However, there are predominantly early-stage systemic sclerosis patients in this study and the patient group is heterogeneous. We included patients with diffuse systemic sclerosis and widespread skin involvement in this study. we found a much higher frequency of fibromyalgia syndrome than indicated in the literature. Considering that systemic sclerosis is a serious disease that significantly impairs quality of life, this finding is very important. In order to relieve the symptoms associated with FMS, it is important to provide them with additional medical support, to provide as much exercise as possible, and to provide group therapies to improve patients’ quality of life. References: [1]Management of Musculoskeletal Involvement in Systemic Sclerosis. Philip Clements. Curr Treatm Opt Rheumatol. 2016 Mar; 2(1): 61–68. [2]Malcarne VL, Hansdottir I, McKinney A, Upchurch R, Greenbergs HL, Henstorf GH, Furst DE, Clements PJ, Weisman MH. Medical signs and symptoms associated with disability, pain, and psychosocial adjustment in systemic sclerosis. J Rheumatol. 2007;34:359–367. Disclosure of Interests: None declared