CLINICAL-FEATURES OF ANA-POSITIVE AND ANA-NEGATIVE PATIENTS WITH FIBROMYALGIA

Patients with fibromyalgia (FM) may present manifestations such as art hralgias, subjective joint swelling, fatigue, and ANA positivity, whic h are suggestive of a connective tissue disorder (CTD). The purpose of this study was to determine whether patients with FM and positive ant inuclear antibodies (ANA), have features distinct from those who are A NA negative. Sixty-nine patients with FM who were participating in a l ongitudinal study were evaluated for the presence or absence of ANA (b y indirect immunofluorescence using Hep-2 cells as substrates) and for manifestations suggestive of a systemic CTD. Eighteen of the 69 patie nts with FM (26.1%) were ANA positive at a titer greater than or equal to 1:80 (similar to 78%, speckled pattern); their clinical manifestat ions were comparable to those of the 51 ANA-negative patients. Thus, A NA was not associated with any difference in the pattern of FM. Also, ANA-positive patients with FM are no more likely to exhibit symptoms s uggestive of systemic CTDs than ANA-negative patients. Caution should be exercised in the management of these patients to avoid the unnecess ary use of therapeutic agents not otherwise indicated and potentially toxic.