Background Chronic widespread pain (CWP) is a healthcare problem that has a considerable social impact because it is frequent (a prevalence of 4.7-11.2%) and causes a poor quality of life. It can be a consequence of many disorders; however, there are few reports concerning its prevalence during the course of other diseases. Systemic sclerosis (SSc) is a multisystem autoimmune disease characterised by vascular injury and progressive skin and organ fibrosis. The involvement of internal organs is responsible for higher morbidity and mortality rates, and the patients quality of life can be worsened by the presence of CWP.
Objectives The aim of this study was to compare the prevalence of CWP in patients with limited (l-SSc) or diffuse SSc (d-SSc) and healthy controls.
Methods All of the patients were evaluated in terms of the disease activity, markers of inflammation, the presence of antibodies, serum vitamin D levels, and disease duration. All of the subjects (patients and controls) completed a psychic stress test (the Kessler 10-item test), a test of the quality of sleep and fatigue (Flinder’s Fatigue Scale), and a test of catastrophism.
Results The study evaluated 48 patients with SSc (42 females and 6 men; mean age 59.4±13.5, range 24-81), 31 with l-SSc and 17 with d-SSc (disease duration 8±5 years). The overall prevalence of CWP in the patients was 27.1%, much higher than that expected in the general population. The prevalence of CWP in the patients with l-SSc and d-SSc was respectively 17.6% and 32.3%, but the difference was not statistically significant. There was no correlation between the prevalence of CWP and the dergree of cutaneous involvement (modified Rodnan Skin Score), but there was a correlation with older age (p=0.033) and the ESR (p=0.041). Logistic regression showed that the only variable favouring the development of CWP was the presence of anti-centromeric antibodies (ACAs, p=0.08).
Conclusions The higher prevalence of CWP among patients with SSc does not correlate with the clinical manifestations of the disease. However, it does correlate with advanced age and the presence of inflammation. The presence of ACAs is a risk factor for CWP, which suggests that patients with l-SSc develop CWP more frequently than those with d-SSc.
Disclosure of Interest None Declared