Objectives To examine the relation between chronic fatigue syndrome (fibromyalgia), disease activity, and quality of life measures in patients with systemic lupus erythematosus (SLE).
Methods Consecutive 40 patients attending king fahad hospital, Jeddah and Saudi German hospital, Jeddah; were studied. All patients fulfilled the American college of rheumatology (ACR) criteria for the Classficiation of SLE. Disease activity was assessed using the SLE disease activity index (SLEDAI) Fatigue was measured by the Fatigue Severity Score (FSS) and health status by the SF-36 questionnaire. In all cases a fibromyalgia tender point count was also performed. The Fatigue Severity Score (FSS) and a visual analogue scale (VAS) were recorded in all patients.The FSS is a nine-item questionnaire, each item being scored from 1 to 7 and an overall score computed in the range of 1 to 7.Functional status was measured using the Medical Outcomes Study Short Form Health Survey (SF-36).
Results 40 patients were studied, 38 females and 2 males. Their mean (SD) age were 40 (10.5) years and disease duration 9.5 (8.0) years. There were no differences with regard to patient characteristics, disease activity, fatigue severity or tender point score between the 40 patients with complete information about the SF-36.
The mean SLEDAI score at study was low. The level of fatigue reported was high; mean (SD) 6.06 (2.8).
The FSS did not correlate with the SLEDAI. The fatigue severity score had a poor correlation with disease activity by SLEDAI (p=0.05).
Fatigue severity score correlated with the tender point count (p=0.001), and negatively with all domains of the SF36 (p=0.001). Disease activity accounted for only 5%of the variance in fatigue severity reported by patients.
Conclusions In the studied group of systemic lupus erythematosus (SLE) patients, fatigue severity is related to poor health condition and higher tender point count.In our patients with SLE, factors associated with quality of life and fibromyalgia seem to have a greater influence on the severity of fatigue than does the level of disease activity.
Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, et al. The 1982 revised criteria for the classfication of systemic lupus erythematosus. Arthritis Rheum. 1982;25.
Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch. Neurol. 1989;46.
Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH. Derivation of the SLEDAI. A disease activity index for lupus patients. The Committee on Prognosis Studies in SLE. Arthritis Rheum 1992;35:630–640.
Krupp LB, La Rocca NG, Muir-Nash J, Steinberg AD. The Fatigue Severity Score. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 1989;46:1121–3.
White PD, Grover SA, Kangro HO, Thomas JM, Amess J, Care AW. The validity and reliability of a fatigue syndrome that follows glandular fever. Psychol Med 1995;25:917–24.
Ware JE, Sherbourne CD. MOS 36-item short form health survey (SF36). Med Care 1992;30:473–83.
Disclosure of Interest None Declared