The interaction between autoimmune diseases and fibromyalgia: risk, disease course and management

Abstract

Fibromyalgia (FM) is a common non-autoimmune rheumatologic disease with a wide range of symptoms that worsen the clinical status of patients. Several authors have tried to identify a putative autoimmune biomarker but, unfortunately, without positive results. Moreover, the altered pain perception characteristic of FM patients is similar in other autoimmune rheumatologic and non-rheumatologic diseases, in fact the pain in FM is not strictly tied to an organic disease, the perception and the severity of it are comparable with those of autoimmune conditions, for example, the polymyalgia rheumatica. In this review, we focus on the FM comorbidities, especially related to autoimmune rheumatologic and non-rheumatologic conditions.

Keywords::

• autoantibody
• autoimmune disease
• fibromyalgia
• non-rheumatologic autoimmune disease
• rheumatologic autoimmune disease

Acknowledgement

The authors are grateful to W Doherty for assistance in the preparation of the manuscript.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Fibromyalgia (FM) is a common rheumatologic disease characterized by widespread pain, multiple painful tender points and several non-specific symptoms. The etiology remains unclear.

• • There are no specific biomarkers for FM.

• • Autoimmunity, especially with regards to the thyroid, seems related to development of FM.

• • Several antibodies have been studied, with conflicting results.

• • FM acerbates the other rheumatologic disease symptoms, such as rheumatoid arthritis.

• • The possibility of developing a connective tissue disease in patients with FM is equal in the normal population.

• • The presence of mood disturbances associated to a chronic disease could partially justify the presence of FM both a systemic rheumatologic diseases and in some organ-specific autoimmune diseases, such as autoimmune thyroid disease and diabetes mellitus.

• • There is no specific treatment for FM, however, a multidisciplinary (pharmacological and non-pharmacological) approach seems to be useful in improving the disease status.