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Fibromyalgia in 300 adult index patients with primary immunodeficiency

1, 2, 3, 4

 

  1. Department of Medicine, Brookwood Medical Center, Birmingham, AL; Southern Iron Disorders Center, Birmingham, AL; and Department of Medicine, University of Alabama at Birmingham, AL, USA. ironmd@isp.com
  2. Department of Medicine, Brookwood Medical Center, Birmingham, AL; Southern Iron Disorders Center, Birmingham, AL; and Brookwood Biomedical, Birmingham, AL, USA.
  3. Southern Iron Disorders Center, Birmingham, AL, USA.
  4. Southern Iron Disorders Center, Birmingham, AL; and Department of Microbiology, University of Alabama at Birmingham, USA.

CER10282
2017 Vol.35, N°3 ,Suppl.105
PI 0068, PF 0073
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PMID: 28422000 [PubMed]

Received: 28/01/2017
Accepted : 28/03/2017
In Press: 19/04/2017
Published: 29/06/2017

Abstract

OBJECTIVES:
We sought to determine the prevalence and clinical and laboratory associations of fibromyalgia in adults with primary immunodeficiency (immunoglobulin (Ig) G subclass deficiency (IgGSD) and common variable immunodeficiency (CVID).
METHODS:
We performed a retrospective analysis of these observations in 300 non-Hispanic white adult index patients with recurrent/severe respiratory tract infections and IgGSD or CVID: age; sex; IgGSD; fibromyalgia; chronic fatigue; autoimmune conditions (ACs); interstitial cystitis (IC); diabetes; body mass index; serum Ig isotypes; blood lymphocytes and subsets; and human leukocyte antigen (HLA)-A and -B types and haplotypes. We performed univariate comparisons, logistic multivariable regressions, and an analysis of covariance.
RESULTS:
Mean age was 49 ± 12 (standard deviation) y. There were 246 women (82.0%). IgGSD was diagnosed in 276 patients (92.0%). Fifty-six patients had fibromyalgia (18.7%; female:male 13:1). Other characteristics included: chronic fatigue, 63.0%; aggregate ACs, 35.3%; Sjögren’s syndrome, 8.0%; IC, 3.0%; diabetes, 10.3%; and HLA-A*29, B*44 positivity, 9.7%. Prevalences of female sex; chronic fatigue; IC; and HLA-A*29, B*44 positivity were greater in patients with fibromyalgia. Logistic regression on fibromyalgia revealed three positive associations: chronic fatigue (p=0.0149; odds ratio 2.6 [95% confidence interval 1.2, 5.6]); Sjögren’s syndrome (p=0.0004; 5.2 [2.1, 13.2]); and IC (p=0.0232; 5.7 [1.3, 25.7]). In an analysis of covariance, there were significant interactions of chronic fatigue, Sjögren’s syndrome, and interstitial cystitis on fibromyalgia.
CONCLUSIONS:
Fibromyalgia is common in non-Hispanic white adult index patients with primary immunodeficiency, especially women. Chronic fatigue, Sjögren’s syndrome, and IC are significantly associated with fibromyalgia after adjustment for other independent variables.

Rheumatology Article