FIBROMYALGIA AND SJOGRENS-SYNDROME - CLIN ICAL AND METHODICAL ASPECTS

The prevalence of fibromyalgia in primary (n = 18) or secondary (n = 2 0) Sjogren's syndrome was examined. In all patients with Sjogren's syn drome as well as in 31 fibromyalgia patients and 20 healthy individual s measurements of pressure pain threshold were done by palpation and d olorimetry. Widespread pain, functional complaints, as well as depress ion were determined by a questionnaire. The results show a high freque ncy of fibromyalgia in the group of patients with pSS (44%), 72% of PS S patients reported widespread pain. Only 5% of the sSS patients fulfi lled the ACR criteria for fibromyalgia and 40% of this group reported on widespread pain. Dolorimetry measures at tender or control points r evealed that the pressure pain threshold was significantly reduced in all patient groups with healthy controls. There were only small differ ences between the clinical groups. Within the different groups examine d there was a close correlation between dolorimetric threshold at tend er and control points. In contrast to self-estimated widespread pain t he pressure pain threshold was not closely related to functional compl aints in the patient groups. The prevalence of depression was increase d in both pSS and FM patients, in contrast to the other groups. The re sults suggest to include Sjogren's syndrome into the differential diag nosis of FM. The dolorimetric results were interpreted as an argument against the actual tenderpoint concept. They support the view that pat ients with FM rather represent an arbitrary coincidence of widespread pain and elevated tenderness on pressure.