ASSOCIATION BETWEEN FIBROMYALGIA AND MOOD DISORDER IN PATIENTS WITH SYSTEMIC LUPUS ERITHEMATHOSUS: A SERIES OF 77 PATIENTS

Background: Fibromyalgia (FM) and mood disorders, like depression (DD) and anxiety (AD), are present in patients with Systemic Lupus Erythemathosus (SLE). The relationship between mood disorders and pain hypersensitivity and lupus activity has not been well established [1,2]. We studied this relationship with disease activity and its impact on quality of life.Objectives: To determine the prevalence of FM, AD and DD in a cohort of patients with SLE and to establish its relationship with disease activity, and health status.Methods: 77 patients with SLE, from the Rheumatology outpatients clinic were evaluated prospectively and consecutively. The diagnosis of SLE was made according to the ACR criteria (1997) and the diagnosis of FM was made by the ACR criteria (1990). The presence of DD or AD was determined by the Hamilton Test, both with > 14 points. We registered age, gender and race. SLEDAI score will measure SLE activity >5 points and an alteration of biological parameters: Erythrocyte Sedimentation Rate (ESR) >20, C-Reactive Protein (PCR) >0.8, anti-DNA antibodies (DNA), Complement 3 (C3) <80, Complement 4 (C4) <10, Complement H50 (CH50). They also complete a Short-Form 12 – Spanish version questionnaire (SF12). Statistical analysis of prevalence and association was done using the SpSS program 12 ver.Results: 77 patients were evaluated, 74/94.7% females (84.4% caucasian, 9.1% south american, 3.9% eastern asian, 1.3% western asian), median age 43.16(17.06). 38.2% had a diagnosis of FM; 17.1% had DD; 34.2% had AD; 3.9% SLEDAI>5; 37.3% ESR >20; 17.1% PCR >0.8, positive DNA 57.9%, low C3 13.5%, low C4 10.8%, and low CH50 21.2%. In the patients with SLE that had clinical findings of FM, we performed an association analysis whose findings were: association statistical significance between patients with FM and DD (p<0.001); association statistical significance between patients with FM and AD (p<0.001); no association between FM and SLEDAI>5; no association between FM and ESR, CPR, low C3, low CH50; we found an association between absence of FM and low C4 (p=0.019); no differences found about age, gender, and race. Presence FM Absence FM p value Age 44.8 (18.6) 42.2 (16.2) NS Gender (females) 27/96.4% 46/97.9% NS SF12 (physical) 34.1 (10.6) 45.1 (10.4) <0.001 SF12 (mental) 34.7 (11.4) 45.9 (12.5) <0.001 Conclusion: prevalence of FM in patients with SLE is high (38.2%), and is intense associated with the presence of AD and/or DD. This association has not relation with SLE activity. In patients with SLE, the coexistence of FM implies worse health status perception (as mental as physical components, by SF12). Its necessary evaluate the presence of FM, AD and DD in all patients to understand their clinical symptoms and to improve their quality of life.References: 1. Psychological distress and changes in the activity of systemic lupus erythematosus. Rheumatology 2002;41:184-188.2. Fibromyalgia in systemic lupus erythematosus: prevalence and clinical implications. Buskila D. Clin Rev Allergy Immunol. 2003;25:25-8.Citation: Ann Rheum Dis, volume 66, supplement II, year 2007, page 485Session: SLE, Sjogren's and APS – clinical aspects and treatment