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

Year 2025, Volume: 12 Issue: 2, 82 - 87, 31.08.2025

Derya Cirakoglu

https://doi.org/10.56941/odutip.1725934

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

References

• Elia A, Zucchi D, Silvagni E, Oliva M, Cascarano G, Cardelli C, et al. Systemic lupus erythematosus: one year in review 2025. Clin Exp Rheumatol. 2025;43(3):397-406. doi:10.55563/clinexprheumatol/m0pi1k
• Tsokos GC. Autoimmunity and organ damage in systemic lupus erythematosus. Nat Immunol 2020;21(6):605–614. https:// doi.org/ 10. 1038/ s41590- 020- 0677-6
• Iannuccelli C, Favretti M, Dolcini G, Di Carlo M, Pellegrino G, Bazzichi L, et al. Fibromyalgia: one year in review 2025. Clin Exp Rheumatol. 2025;43(6):957-969 doi: 10.55563/clinexprheumatol/buhd2z.
• Buskila D, Press J, Abu-Shakra M. Fibromyalgia in systemic lupus erythematosus: prevalence and clinical implications. Clin Rev Allergy Immunol. 2003;25(1):25–28. https:// doi.org/10.1385/CRIAI:25:1:25
• Monteiro JAM, Gama ALH, Oliveira JCS, Falcao MV, Melo AKG, Egypto DCS, et al. Fibromyalgia comorbidity in Systemic Lupus Erythematosus patients: assessing impact on quality of life. Adv Rheumatol. 2024;64(1):90. doi:10.1186/s42358-024-00432-5.
• Bhargava J, Goldin J. Fibromyalgia. 2025 Jan 31. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan–. PMID: 31082018.
• Dai X, Fan Y, Zhao X. Systemic lupus erythematosus: updated insights on the pathogenesis, diagnosis, prevention and therapeutics. Signal Transduct Target Ther. 2025;10(1):102. doi:10.1038/s41392-025-02168-0
• Corbitt K, Carlucci PM, Cohen B, Masson M, Saxena A, Belmont HM, et al. Clinical and Serologic Phenotyping and Damage Indices in Patients With Systemic Lupus Erythematosus With and Without Fibromyalgia. ACR Open Rheumatol. 2024;6(4):172-178. doi:10.1002/acr2.11641
• Murphy AE, Minhas D, Clauw DJ, Lee YC. Identifying and managing nociplastic pain in individuals with rheumatic diseases: a narrative review. Arthritis Care Res (Hoboken). 2023;75:2215–2222.
• Pisetsky DS, Clowse MEB, Criscione-Schreiber LG, Rogers JL. A novel system to categorize the symptoms of systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2019;71:735–741.
• Somers EC, Marder W, Cagnoli P, Lewis EE, DeGuire P, Gordon C, et al. Population-based incidence and prevalence of systemic lupus erythematosus: the Michigan Lupus Epidemiology and Surveillance program. Arthritis Rheumatol. 2014;66(2):369-378. doi:10.1002/art.38238