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THU0353 The prevalence of vitamin D deficiency in 55 new patients diagnosed with fibromyalgia at first visit to rheumatology outpatient clinics in cork, ireland
  1. O.E. Hussein,
  2. W.J. Tee,
  3. M.J. Regan
  1. Rheumatology, South Infirmary-Victoria University Hospital, Cork, Ireland

Abstract

Background Fibromyalgia (FM) is a chronic hypersensitivity pain syndrome with altered central pain processing. Whether vitamin D deficiency contributes to this pain syndrome has not been clearly defined.

Objectives From among all new patients referred over a three-year period to our clinics by G.P.s, our aims were to identify the new patients diagnosed with FM and to analyse their vitamin D levels.

Methods At first visit to our clinics, we record patients’ demographics, their musculoskeletal diagnosis and pre-determined clinical data in a database which is continually updated at follow-up visits. We performed a retrospective database review of all new patients seen between 1/1/2009 – 31/12/2011 to identify patients diagnosed anew with FM. Using ACR 1990 FM criteria, the diagnosis was confirmed by chart review and their vitamin D levels were recorded. Vitamin D deficiency was defined as a 25 hydroxy-vitamin D level of <75 nmol/L (<30ng/mL); severe deficiency as <25 nmol/L.

Results Between 1/1/2009 – 31/12/2011, 696 new patients were seen: 62 (9%) had FM of which 60 (97%) were female, 2 were male. The average age was 43 years (range 18 - 72). Race: 60 Caucasian (97%), one African (1.5%), one Asian (1.5%). In 54 of the FM patients, FM was the only musculoskeletal diagnosis. Eight patients had FM and another musculoskeletal condition at presentation (5 osteoarthritis, 1 gout and osteoarthritis, 1 psoriatic arthritis, 1 shoulder capsulitis). Vitamin D levels were available for 55 of these FM patients (89%) with results as follows: <75 nmol/L in 42 (76%), <25 nmol/L in 12 (22%) and ≥75 nmol/L in 13 (24%) patients.

Conclusions Three-quarters of newly diagnosed FM patients had hypovitaminosis D and more than 1 in 5 had severe deficiency. This could reflect background vitamin D deficiency which is prevalent in Ireland. Another postulate is that some non-specific pain syndromes are caused by subclinical osteomalacia misdiagnosed as FM. Should vitamin D deficiency be corrected before we label patients as having FM? More research is needed in this area.

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  2. Fibromyalgia–should we be testing and treating for vitamin D deficiency? Daniel D, Pirotta MV.

  3. Correlation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: a randomized controlled trial. Arvold DS, Odean MJ, Dornfeld MP, Regal RR, Arvold JG, Karwoski GC, Mast DJ, Sanford PB, Sjoberg RJ.

Disclosure of Interest None Declared

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