Hepatitis C Virus Might Induce Fibromyalgia
A
Portland Oregon study suggests hepatitis C may trigger
fibromyalgia. The study is the first to show a link between the
two illnesses.
Fibromyalgia often arises after a traumatic event or an illness.
Several infections have previously been proposed as potential
inciters of fibromyalgia, including Lyme disease and the human
herpes virus-6.
Published in the Journal of Clinical Rheumatology’s August 1996
issue, the 12-patient study determined that the relationship
between hepatitis C virus and fibromyalgia followed three
distinct patterns:
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In nine patients, fibromyalgia developed as a long-term
complication of the hepatitis, arising on average 13.4 years
after the virus was acquired.
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In two patients, fibromyalgia arose simultaneously with the
hepatitis C infection.
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In one patient, pre-existing fibromyalgia was significantly
worsened by the hepatitis C.
Six of the 12 patients were dosed with fibromyalgia after
initial evaluations for musculoskeletal complaints. All had the
chance of contracting hepatitis C through either blood or body
fluid exposure. Three used intravenous blood products, one
experienced an occupational needle stick, three had tattoos,
three used intravenous drugs, and two engaged in promiscuous
sexual practices.
The reason for the link between hepatitis C and fibromyalgia is
unknown. The authors propose, however, that hepatitis C causes
chronic activation of the immune system that leads to muscle
aching, fatigue, mental changes, sleep abnormalities, and
alterations of the neuroendocrine system.
The patients with both hepatitis C and fibromyalgia could be
distinguished from most other patients with fibromyalgia alone
because they had symptoms unusual to fibromyalgia. These
symptoms include synovitis (inflammation of the membrane around
a joint, bursa, or tendon) and vasculitis (inflammation of a
blood or lymph vessel). In addition, laboratory findings pointed
to a disease process other than fibromyalgia.
The study was conducted at Oregon Health Sciences University and
Portland Adventist Hospital.
Source: "Fibromyalgia: A prominent feature in patients with
musculoskeletal problems in chronic hepatitis C, A report of 12
patients,"by A. Barkhuizen, G.S. Schoepflin, and R.M. Bennett,
Journal of Clinical Rheumatology, Vol. 2.
Questions & Answers about Fibromyalgia
National Institute of Arthritis and Musculoskeletal and Skin
Diseases
 What is
Fibromyalgia?
Fibromyalgia is a chronic disorder characterized by
widespread musculoskelatal pain, fatigue, and multiple tender
points. “Tender points” refers to tenderness that occurs in
precise, localized areas, particularly in the neck, spine,
shoulders, and hips. People with this syndrome may also
experience sleep disturbances, morning stiffness, irritable
bowel syndrome, anxiety and other symptoms.
How many people have Fibromyalgia?
According to the American College of Rheumatology,
fibromyalgia affects 3 to 6 million Americans. It primarily
occurs in women of childbearing age, but children, the elderly,
and men can also be affected.
What Causes Fibromyalgia?
Although the cause of fibromyalgia is unknown, researchers
have several theories about causes or triggers of the disease.
Some scientists believe that the syndrome may be caused by an
injury or trauma. This injury may affect the central nervous
system. Fibromyalgia may be associated with changes in muscle
metabolism, such as decreased blood flow, causing fatigue and
decreased strength. Others believe the syndrome may be triggered
by an infectious agent such as a virus in susceptible people,
but no such agent has been identified.
How is Fibromyalgia Diagnosed?
Fibromyalgia is difficult to diagnose because many of the
symptoms mimic those of other diseases. The physician reviews
the patient’s medical history and makes a diagnosis of
fibromyalgia based on a history of chronic widespread pain that
persists more than 3 months. The American College of
Rheumatology (ACR) has developed criteria for fibromyalgia that
physicians can use in diagnosing the disease. According to ACR
criteria, a person is considered to have fibromyalgia if he or
she has wide-spread pain in combination with tenderness in at
least 11 of 18 specific tender point sites.
How is Fibromyalgia Treated?
Treatment of fibromyalgia requires a comprehensive approach.
The physician, physical therapist, and patient may all play an
active role in the management of fibromyalgia. Studies have
shown that aerobic exercise, such as swimming and walking,
improve muscle fitness and reduces muscle pain and tenderness.
Heat and message may also give short-term relief. Antidepressant
medications may help elevate mood, improve quality of sleep, and
relax muscles. Fibromyalgia patients may benefit from a
combination of exercise, medication, physical therapy, and
relaxation.
What Research is Being Conducted on Fibromyalgia?
The NIAMS is sponsoring research that will increase
understanding of the specific abnormalities that cause and
accompany fibromyalgia with the hope of developing better ways
to diagnose, treat and prevent this disorder.
Recent NIAMS studies show that abnormally low levels of the
hormone cortisol may be associated with fibromyalgia. At Brigham
and Women’s Hospital in Boston, and at the University of
Michigan Medical Center in Ann Arbor, researchers are studying
regulation of the function of the adrenal gland (which makes
cortisol) in fibromyalgia. People whose bodies make inadequate
amounts of cortisol experience many of the same symptoms as
people with fibromyalgia. It is hoped that these studies will
increase understanding about fibromyalgia and may suggest new
ways to treat the disorder.
Other NIAMS research studies are looking at different aspects of
the disease. At the University of Alabama in Birmingham,
researchers are concentrating on how specific brain structures
are involved in the painful symptoms of fibromyalgia.
Researchers at Vanderbilt University in Nashville are using
magnetic resonance imaging (MRI) and magnetic resonance
spectroscopy (MRS) techniques to study patients with
fibromyalgia. MRI and MRS are powerful tools that have been
shown to be useful in evaluating muscle disorders and muscle
performance. At the New York Medical College in Valhalla,
scientists are investigating the cause of a post-Lyme disease
syndrome as a model for fibromyalgia. Some patients develop a
fibromyalgia-like condition following Lyme disease, an
infectious disorder associated with arthritis and other
symptoms.
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