Abstract
Among 215 patients who were diagnosed with rheumatoid arthritis (RA) according to the criteria established by the American College of Rheumatology (ACR) in 1987, concomitant Fibromyagia (FM), which was evaluated according to the ACR criteria published in 1990, was detected in 20 (9.3%).
In 2 of these patients, FM symptoms initially developed, leading to RA. The mean interval until RA development was1year. In 12, the concomitant development of RA and FM was confirmed on the initial consultation. Five patients were negative for C-reactive protein (CRP), and 7 were positive for CRP. The former showed a depressive state. In 5 of the latter, a depressive state was noted. In the other 6 patients, FM symptoms appeared during the course of RA. In 3, there was a marked increase in the CRP level after the onset of FM (mean rate of increase: 1.9mg/dl). In 2, the presence of stressor was confirmed. In the remaining patients, no etiological factor could be specified.
Thus, the pathogenesis of FM in the presence of RA may involve a depressive state, mental/physical stress, and inflammatory stress, including a increase in the CRP level, in addition to its predisposition.
