ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2182

Prevalence of Fibromyalgia Is Increased in Primary Sjögren’s Syndrome Compared with SLE and Associated with Depression and Severe Vitamin D Deficiency

Byoong Yong Choi1, Hye Jin Oh2, Jun Won Park3, Bon Seung Ku2, Sung Hae Chang2, Eun Young Lee2, Eun Bong Lee2 and Yeong Wook Song4, 1Division of Rheumatology, Department of Internal Medicine, Seoul Medical Center, Seoul, South Korea, Seoul, South Korea, 2Internal Medicine, Seoul National University Hospital, Seoul, South Korea, 3Division of Rheumatology, Department of Internal Medicine, Rheumatology, Seoul National University, Seoul, South Korea, 4Internal Medicine,, Seoul National University Hospital, Seoul, South Korea

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Sjögren's Syndrome - Clinical

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Although clinical features of primary Sjögren’s syndrome (pSS) overlap with those of fibromyalgia (FM), the relationship between FM and pSS has remained unclear. Furthermore, ACR preliminary diagnostic criteria for FM developed in 2010 do not require a tender point exam and focus on the presence of widespread pain or somatic symptoms. This cross-sectional study was conducted to investigate the prevalence and risk factors of FM in pSS.

Methods:

Sixty-nine with pSS and 97 with systemic lupus erythematosus (SLE) were assessed to identify the presence of FM based on the 2010 ACR criteria. Clinical and laboratory data for pSS or SLE were collected from all patients. Additional assessments included number of tender points (TPs), visual analogue scale (VAS) of pain, fatigue, and Fibromyalgia Impact Questionnaire, Hamilton depression rating scale 17-items (HAM-D). Serum 25-hydroxy vitamin D (25-OH-D) levels were determined in patients with pSS. Disease activities in pSS were measured using EULAR Sjögren’s Syndrome Disease Activity Index (ESSDAI).

Results:

The prevalence of FM was 28% [95%CI: 17.0-38.0] in pSS and 3.0% [95% CI: 0-7.0] in SLE. Primary SS patients had more frequent somatic symptoms such as myalgia (p=0.016), insomnia (p=0.048), headache (p=0.018) and cognitive dysfunction (p<0.001) compared to SLE patients. The widespread pain index (WPI) and score of somatic symptom scale (SS scale) in pSS patients were also significantly higher than those of SLE. Multiple linear stepwise regression analysis showed that HAM-D, ESSDAI and serum 25-OH-D levels were the significant determinants of WPI; HAM-D and serum 25-OH-D levels were also the significant determinants of score of SS scale in pSS patients. Depression and severe 25-OH-D deficiency (<10 ng/mL) in pSS was associated with presence of FM (OR: 34.00 [95% CI: 6.72-171.9], OR: 4.15 [95% CI: 1.09-15.83], respectively).

Conclusion:

The prevalence of FM was higher in patients with pSS compared to SLE. Depressive mood and severe vitamin D deficiency in pSS patients was associated with the presence of FM.

Disclosure:

B. Y. Choi,
None;

H. J. Oh,
None;

J. W. Park,
None;

B. S. Ku,
None;

S. H. Chang,
None;

E. Y. Lee,
None;

E. B. Lee,
None;

Y. W. Song,
None.

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