Background Studies on the relationship between Fibromyalgia (FM), a generalized pain disorder with up to 2% prevelance and Behcet’s Disease (BD), a systemic, inflammatory vasculitis, is limited.
Objectives We conducted the present study to assess the prevalance of FM in BD diagnosed according to 2010 American College of Rheumatology (ACR) criteria and to evaluate the association of FM with disease activity, disability, depression, anxiety and quality of life (QoL) in BD patients.
Methods Thirty-three patients followed as BD (F/M:17/16, mean age: 41.6 years) fullfilling the International Study Group Criteria (ISG,1990), 24 patients with systemic lupus erythematosus (SLE) (F/M:23/1, mean age: 39.6 years) and 23 healthy controls (HC) (F/M: 11/12, mean age: 44.4 years) were enrolled to the study. All patients were examined for FM tender points (according to ACR 1990 criteria for the classification of FM) by two observers (kappa=0.6) and asked to complete new ACR 2010 FM questionnaire for FM (ref1). The clinical activity score in BD was determined by Behcet’s Syndrome Activity Scale (BSAS) and SLE by SLEDAI. SF-36 and hospital anxiety and depression scales were also used to assess QoL together with health assessment questionnaire (HAQ).
Results Ten (30.3%) BD patients met the ACR 2010 criteria for FM, compared to 4 (16.7%) in SLE and 3 (13%) in HC (p=0.2). BSAS score correlated with FM (r=0.5, p=0.002), whereas FM and SLEDAI had no correlation (r=0.2,p=0.1). Anxiety (7.7±5.1, 6.2±3.8 and 5.7±5.5 in BD, SLE and HC, respectively) (p>0.05), and depression scores were not significantly different (6.7±3.8, 5.9±4.8 and 4.4±3.8 in BD, SLE and HC respectively) (p>0.05) between the 3 groups. SF-36 physical component scores (PCS) were observed significantly lower in BD patients [36.9 (15-60), 46.7 (24.5-59.6) and 59.6 (30.6-59.1) in BD, SLE and HC, respectively] (p<0.01). However, SF36-mental components (MCS) were not different between the groups [43.8 (21-60), 41 (27-60) and 50.5 (21-62) in BD, SLE and HC respectively] (p>0.05). There were negative correlations between SF36 –PCS and -MCS with FM (r=-0.5 and r=-0.2). HAQ scores were also mildly impaired in BD and SLE patients compared to HC [0.1 (0-0.9), 0.1 (0-1.3) and 0 (0-0.5), respectively](p<0.01). HAQ score correlated with FM (r=0.3, p=0.03) in BD.BSAS score (median) was 18.5 (0-60) in BD and %45.5 (n=15) of the BD group had a mucocutaneous and %54.5 (n=18) had major (ocular, vascular or central nervous system) disease. The presence of FM did not differ significantly between the patients with mucocutenous and major organ involvement (p=0.6). No significant difference were also observed between SF36 parameters, HAQ scores, BSAS score and anxiety-depression scores between the two subsets.
Conclusions Fibromyalgia, with new diagnostic criteria, seem to be more prevelant in BD compared to previous studies. Association of BSAS and SF-36 with FM in our study group suggests that disease activity and QoL status seems to influence FM presence in BD.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, Russell AS, Russell IJ, Winfield JB, Yunus MB. The American College of Rheumatology preliminary diagnostic criteria forfibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10.
Disclosure of Interest None Declared