A Disease Hidden in The Symptoms of Fibromyalgia: Systemic Lupus Erythematosus

Abstract

Systemic lupus erythematosus (SLE) and fibromyalgia syndrome (FMS) are two diseases with similar clinical symptoms, but different pathophysiological mechanisms. Both diseases are chronic and generally more prevalent in women. Common symptoms include widespread muscle and joint pain, fatigue, sleep disorders and cognitive problems such as forgetfulness and difficulty concentrating. However, despite their similar symptoms, the two diseases require quite different treatment approaches. Therefore, a correct diagnosis is critical for patients to access appropriate treatment and improve their quality of life. We present the case of a 49-year-old female patient who had been under observation for two years with a diagnosis of FMS. Despite treatment, her symptoms persisted and she was subsequently diagnosed with SLE in addition to FMS. Initially, the patient presented with joint pain, weakness, fatigue and sleep disorders; however, there were no objective clinical findings suggesting SLE. Subsequent objective findings and laboratory values led a rheumatologist to diagnose SLE, and hydroxychloroquine sulfate treatment was started.

Keywords

• Systemic lupus erythematosus
• Fibromyalgia
• Pain

Fibromiyalji Semptomlarına Gizlenmiş Bir Hastalık: Sistemik Lupus Eritamatozus

Abstract

Systemic lupus erythematosus (SLE) ve Fibromyalgia sendromu (FMS), benzer klinik semptomlar gösterebilen, ancak farklı patofizyolojik mekanizmalara sahip iki hastalıktır. Her iki hastalıkta kronik seyir gösterir ve genellikle kadınlarda daha sık rastlanır. Yaygın kas ve eklem ağrısı, yorgunluk, uyku bozukluklarının yanı sıra unutkanlık, konsantrasyon güçlüğü gibi bilişsel problemler her iki hastalığın ortak semptomları olarak karşımıza çıkabilmektedir. İki hastalıkta benzer semptomlara sahip olsalar da tedavi yaklaşımları oldukça farklıdır. Bu nedenle doğru tanı, hastaların uygun tedaviye ulaşmaları ve yaşam kalitelerinin artırılması açısından kritik öneme sahiptir. Biz 49 yaşında iki yıldır FMS tanısıyla takip edilen, tedaviye rağmen şikayetleri devam eden, sonrasında FMS tanısına ek olarak SLE tanısı konulan bir kadın hastayı sunuyoruz. Hastanın başlangıç semptomları eklem ağrıları, halsizlik, yorgunluk, uyku bozukluğu olmakla birlikte kliniğinde SLE’yi düşündüren objektif bulgular bulunmamaktaydı. Sonrasında gelişen objektif bulgular ve laboratuvar değerlerine dayanılarak hastaya romatoloji uzmanı tarafından SLE tanısı konulmuş ve hidroksiklorakin sülfat tedavisine başlanmıştır.

Keywords

• Sistemik lupus eritematozus
• Fibromiyalji
• Ağrı

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