FIBROMYALGIA SYNDROME IN CHILDREN AND ADOLESCENTS - CLINICAL-FEATURESAT PRESENTATION AND STATUS AT FOLLOW-UP

Objectives. To 1) describe the characteristic features of fibromyalgia syndrome (FS) in a pediatric population, 2) note similarities and dif ferences with FS in adults, and 3) determine outcome after treatment. Setting and Design. The Pediatric Rheumatology Clinic at the Universit y of Rochester Medical Center is staffed by two pediatric rheumatologi sts and serves as a regional subspecialty referral service with simila r to 450 annual patient visits, of which similar to 120 are initial ev aluations. A retrospective medical record review from 1989 to 1995 was used to identify and describe the study population, and a structured telephone interview served to determine current status and response to treatment. Results. A total of 45 subjects were identified (41 female ; 42 white; mean age, 13.3 years), of whom 33 were available for telep hone interview at a mean of 2.6 years from initial diagnosis (0.1 to 7 .6 years). Of a possible 15 symptoms associated with FS, subjects repo rted a mean of 8, with >90% experiencing diffuse pain and sleep distur bance. Less frequent were headaches (71%), general fatigue (62%), and morning stiffness (53%). The mean cumulative number of tender points s ummed over all visits was 9.7 (of 18). Telephone interviews showed imp rovement in most patients, with a mean positive change of 4.8 on a sel f-rating scale of 1 to 10 comparing current status to worst-ever condi tion. Conclusions. FS in patients referred to a pediatric rheumatology clinic is characterized by diffuse pain and sleep disturbance, the la tter being more common than that in adults. The mean number of tender points summed over all visits is fewer than the criterion of 11 establ ished for adults at a single visit. The majority of patients improved over 2 to 3 years of follow-up.