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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


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:
In nine patients, fibromyalgia developed as a long-term complication of the hepatitis, arising on average 13.4 years after the virus was acquired.
In two patients, fibromyalgia arose simultaneously with the hepatitis C infection.
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.