Investigation of Pathergy In Patients With Fibromyalgia

Öz

Aim: Recent studies showed increased axon reflex flare reaction to mechanical and chemical stimuli associated with neurogenic inflammation in patients with fibromyalgia (FM). Pathergy test is identified as a non-specific hypersensitivity reaction to minimal trauma. The purpose of this study was to investigate whether patients with FM had a positive pathergy test or not.

Methods: Forty-six patients who met the 1990 American College of Rheumatology (ACR) criteria for the classification of FM and fifty-one healthy control subjects (HCs) were included in this study. Twenty-eight patients with Behcet’s disease were included as disease control for Pathergy test. The Fibromyalgia Impact Questionnaire (FIQ) was used for assessment of functional status in patients with FM. The Nottingham Health Profile was used for assessment of quality of life in all subjects.

Results: There was no significant difference in demographic characteristics between the three groups (p > 0.05). NHP-pain, NHP-physical mobility, NHP-energy, NHP-emotional reaction, NHP-sleep and NHP-total scores were significantly higher in patients with FM compared to HCs (p < 0.001). Neither patients with FM nor HCs had a positive pathergy test.

Conclusion: There are some pathophysiological changes in the skin biopsies of patients with FM; however, these changes are not accompanied by a positive pathergy test.

Key Words: Fibromyalgia, Pathergy test

Anahtar Kelimeler

• -

ÖZGÜN MAKALE / ORIGINAL ARTICLE

Öz

Amaç: Son çalışmalar fibromiyalji (FM) hastalarında mekanik ve kimyasal uyarılara bağlı olarak oluşan nörojenik inflamasyonla beraber artmış aksonal refleks varlığını ortaya koymuştur. Paterji testi derinin minimal bir travmaya karşı gösterdiği nonspesifik hipersensitivite reaksiyonu olarak tanımlanmaktadır. Bu çalışmada amaç, FM’li hastalarda Paterji testinin pozitif olup olmadığının araştırılmasıdır

Anahtar Kelimeler

• Fibromiyalji, Paterji

Kaynakça

1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Flechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard Jichtbroun AS, Masi AT, McCain GA, Reynolds WJ, Romano TJ, Russell IJ, Sheon RP. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990; 33(2):160-72
2. Clauw DJ. The pathogenesis of chronic pain and fatigue syndromes, with special reference to fibromyalgia. Med Hypotheses. 1995; 44(5):369-78
3. Torresani C, Bellafiore S, De Panfilis G. Chronic urticaria is usually associated with fibromyalgia syndrome. Acta Derm Venereol. 2009; 89(4):389-92
4. ISGfB. Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease. Lancet. 1990; 335(8697):1078-80
5. Burckhardt CS, Clark SR, Bennett RM. The fibromyalgia impact questionnaire: development and validation. J Rheumatol. 1991; 18: 728-733
6. Sarmer S, Ergin S, Yavuzer G. The validity and reliability of the Turkish version of the fibromyalgia impact questionnaire. Rheumatol Int. 2000; 20: 9-12
7. Hunt SM, McKenna SP, McEwen J, Williams J, Papp E. The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A. 1981; 15: 221-9.
8. Kucukdeveci AA, McKenna SP, Kutlay S, Gursel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham health profile. Int J Rehabil Res. 2000; 23: 31-38

9. Baker R.B. Smith EV, Osheik AS. Pathergy test. Practical Neurology. 2011; 11:301-302
10. Kim SH. Skin biopsy findings: Implications for the pathophysiology of fibromyalgia. Med Hypotheses. 2007; 69:141-144
11. Kim SH, Kim DH, Oh DH, Clauw DJ. Characteristic electron microscopic findings in the skin of patients with fibromyalgia--preliminary study. Clin Rheumatol. 2008; 27(3):407-11
12. Salemi S, Rethage J, Wollina U, Michel BA, Gay RE, Gay S, Sprott H. Detection of interleukin 1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha in skin of patients with fibromyalgia. J Rheumatol. 2003; 30(1):146-50
13. Blanco I, Béritze N, Argüelles M, Cárcaba V, Fernández F, Janciauskiene S, Oikonomopoulou K, de Serres FJ, Fernández-Bustillo E, Hollenberg MD. Abnormal overexpression of mastocytes in skin biopsies of fibromyalgia patients Clin Rheumatol. 2010; 29(12):1403-12.
14. Varol A, Seifert O, Anderson CD. The skin pathergy test: innately useful? Arch Dermatol Res. 2010; 302(3):155-68.
15. Tüzün Y, Yazici H, Pazarli H, Yalçin B, Yurdakul S, Müftüoğlu A. The usefulness of the nonspecific skin hyperreactivity (the pathergy test) in Behçet's disease in Turkey. Acta Derm Venereol. 1979; 59(1):77-9.
16. Aydin F, Akpolat T, Senturk N, Bagci H, Yasar Turanli A. Evaluation of pathergy test positivity in familial Mediterranean fever patients and comparison of clinical manifestations of FMF with Behçet's disease. 2009; 28(11):1331-5.
17. Dogan SK, Aytur YK, Atbasoglu C. Assessment of the relatives or spouses cohabiting with the fibromyalgia patients: is there a link regarding fibromyalgia symptoms, quality of life, general health and psychologic status? Rheumatol Int. 2011; 31(9):1137-4