Microcirculation Abnormalities in Patients With Fibromyalgia
Microcirculation Abnormalities in Patients With Fibromyalgia
This unblinded preliminary case-control study was done to demonstrate functional and structural changes in the microcirculation of patients with primary fibromyalgia (FM). We studied 10 women (54.0 ± 3.7 years of age) with FM diagnosed in accordance with the classification criteria of the American College of Rheumatology, and controls in three groups (n = 10 in each group) age-matched women who were healthy or who had rheumatoid arthritis or systemic scleroderma (SSc). All 40 subjects were tested within a 5-week period by the same investigators, using two noninvasive methods, laser fluxmetry and capillary microscopy. The FM patients were compared with the healthy controls (negative controls) and with rheumatoid arthritis patients and SSc patients (positive controls). FM patients had fewer capillaries in the nail fold (P < 0.001) and significantly more capillary dilatations (P < 0.05) and irregular formations (P < 0.01) than the healthy controls. Interestingly, the peripheral blood flow in FM patients was much less (P < 0.001) than in healthy controls but did not differ from that of SSc patients (P = 0.73). The data suggest that functional disturbances of microcirculation are present in FM patients and that morphological abnormalities may also influence their microcirculation.
Vasospastic symptoms occur in about 30% of patients with primary fibromyalgia (FM). These patients present with Raynaud's phenomenon and intolerance to cold. Frodin and colleagues, using nailfold capillaroscopy in FM patients, found slight morphological changes, such as moderate enlargement of capillary loops and variations in calibre. Jeschonneck and colleagues showed decreased microcirculatory blood flow above tender points in FM patients. About 60% to 90% of systemic scleroderma (SSc) patients have Raynaud's phenomenon. In patients with SSc other workers, using videomicroscopy with sodium fluorescein, have found typical changes of the nailfold capillaries, characterised by reduced capillary density, giant capillaries, avascular fields, microhaemorrhages, and disturbance of diffusion. Furthermore, in rheumatoid arthritis (RA), peripheral malperfusion and vasculitis occur, resulting in skin ulcers, neuropathy, necrosis, or gangrene.
Our aim in this preliminary study was to investigate capillary abnormalities and blood flow by two independent objective methods, capillary microscopy and laser Doppler fluxmetry, to obtain evidence of disturbed microcirculation in FM patients.
This unblinded preliminary case-control study was done to demonstrate functional and structural changes in the microcirculation of patients with primary fibromyalgia (FM). We studied 10 women (54.0 ± 3.7 years of age) with FM diagnosed in accordance with the classification criteria of the American College of Rheumatology, and controls in three groups (n = 10 in each group) age-matched women who were healthy or who had rheumatoid arthritis or systemic scleroderma (SSc). All 40 subjects were tested within a 5-week period by the same investigators, using two noninvasive methods, laser fluxmetry and capillary microscopy. The FM patients were compared with the healthy controls (negative controls) and with rheumatoid arthritis patients and SSc patients (positive controls). FM patients had fewer capillaries in the nail fold (P < 0.001) and significantly more capillary dilatations (P < 0.05) and irregular formations (P < 0.01) than the healthy controls. Interestingly, the peripheral blood flow in FM patients was much less (P < 0.001) than in healthy controls but did not differ from that of SSc patients (P = 0.73). The data suggest that functional disturbances of microcirculation are present in FM patients and that morphological abnormalities may also influence their microcirculation.
Vasospastic symptoms occur in about 30% of patients with primary fibromyalgia (FM). These patients present with Raynaud's phenomenon and intolerance to cold. Frodin and colleagues, using nailfold capillaroscopy in FM patients, found slight morphological changes, such as moderate enlargement of capillary loops and variations in calibre. Jeschonneck and colleagues showed decreased microcirculatory blood flow above tender points in FM patients. About 60% to 90% of systemic scleroderma (SSc) patients have Raynaud's phenomenon. In patients with SSc other workers, using videomicroscopy with sodium fluorescein, have found typical changes of the nailfold capillaries, characterised by reduced capillary density, giant capillaries, avascular fields, microhaemorrhages, and disturbance of diffusion. Furthermore, in rheumatoid arthritis (RA), peripheral malperfusion and vasculitis occur, resulting in skin ulcers, neuropathy, necrosis, or gangrene.
Our aim in this preliminary study was to investigate capillary abnormalities and blood flow by two independent objective methods, capillary microscopy and laser Doppler fluxmetry, to obtain evidence of disturbed microcirculation in FM patients.
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