Frequency of Fibromyalgia in Patients with Antiphospholipid Syndrome. a Cross-Sectional Study

Nicole Mouneu Ornelas¹, Laura-Aline Martinez-Martinez², Vijaya Rivera³, Ricardo Alberto Venegas Yañez⁴, Victor Alejandro Escamilla Gomez⁵, Gumaro Acosta Peña⁶, Luis H. Silveira⁷, Angelica Vargas Guerrero³, Luis M. Amezcua-Guerra³ and Manuel Martínez-Lavín³, ¹Internal Medicine, Instituto Nacional de Cardiología - Ignacio Chávez, IGNACIO CHÁVEZ, Mexico, ²Rheumatology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, TX, Mexico, ³Rheumatology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico, ⁴Reumatologia, Instituto Nacional de Cardiología "Ignacio Chavez", Ciudad de México, Mexico, ⁵Rheumatology, Instituto Nacional de Cardiología - Ignacio Chávez, Mexico City, Mexico, ⁶Instituto Nacional de Cardiología, Ciudad de mexico, Mexico, ⁷Rheumatology, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City DF, Mexico

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Antiphospholipid syndrome and fibromyalgia

Session Information

Date: Sunday, November 5, 2017

Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes Poster I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

The observation of several cases with coexistent antiphospholipid syndrome (APS) and fibromyalgia led us to this investigation. The objective was to define the frequency of fibromyalgia in a group of patients with antiphospholipid syndrome.

Methods:

From March 24^th to June 8^th 2017 we studied all APS patients attending our outpatient rheumatology clinic. All of them fulfilled the Sapporo and/or Sydney APS classification criteria. The Institutional Ethics Committee approved the protocol. All patients underwent a history + physical examination with emphasis on musculoskeletal features. All filled-out the following questionnaires: the Revised Fibromyalgia Impact Questionnaire (FIQ-R), the 2016 revision of Wolfe’s Fibromyalgia Diagnostic Criteria, and the quality of life EuroQol 5D-5L. The Damage Index in Thrombotic Antiphospholipid Syndrome (DIAPS) was also obtained. Spearman method was used to correlate APS clinical features with fibromyalgia questionnaire scales. Chi square to compare categorical variables.

Results:

Sixty one patients with APS were included. Their mean age: 44 ± 15 years, 70% are female and 54% have primary APS. The prevalence of fibromyalgia was different when using the 1990 ACR diagnostic criteria (4.9%) compared to Wolfe’s criteria (16.4%) p<0.0001. The frequency of fibromyalgia was not different in patient with primary vs. secondary APS. In those patient who had concurrent APS and fibromyalgia according to Wolfe’s criteria (n = 10), there was a correlation between total number of thrombotic events with headache, depression, and abdominal pain (r=0.636, p=0.048), as well as with FIQ-R balance problems (r=0.754, p=0.012). Oddly, cumulative organ damage measured by DIAPS inversely correlated with FIQ-R quality of sleep (r=-0.820, p=0.004). Quality of life measured by Euro Qol is poorer in APS + fibromyalgia patients (85±16 vs 64±12, p<0.001).

Conclusion:

In this cohort of patients with APS, more individuals can be classified as having concurrent fibromyalgia when the 2016 revised Wolfe’s criteria is used. Recurrent thrombosis is associated to several fibromyalgia symptoms such as headache, depression and abdominal pain. Patients with APS and concurrent fibromyalgia have poorer quality life.

Disclosure: N. M. Ornelas, None; L. A. Martinez-Martinez, None; V. Rivera, None; R. A. Venegas Yañez, None; V. A. Escamilla Gomez, None; G. Acosta Peña, None; L. H. Silveira, None; A. Vargas Guerrero, None; L. M. Amezcua-Guerra, None; M. Martínez-Lavín, None.

To cite this abstract in AMA style:

Ornelas NM, Martinez-Martinez LA, Rivera V, Venegas Yañez RA, Escamilla Gomez VA, Acosta Peña G, Silveira LH, Vargas Guerrero A, Amezcua-Guerra LM, Martínez-Lavín M. Frequency of Fibromyalgia in Patients with Antiphospholipid Syndrome. a Cross-Sectional Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/frequency-of-fibromyalgia-in-patients-with-antiphospholipid-syndrome-a-cross-sectional-study/. Accessed .

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