title: Fibromyalgia, chronic fatigue syndrome, and myofascial pain syndrome.
abstract: Fibromyalgia was almost completely absent from an urban affluent population compared with poor urban and rural communities. Seventeen percent of Gulf War veterans with soft tissue syndromes had fibromyalgia, a much higher rate than was seen in previous studies of rheumatic disease in the military population. A state of central hyperexcitability in the nociceptive system was reported in fibromyalgia. Altered functioning of the stress-response system has been further documented in fibromyalgia and chronic fatigue syndrome. Administration of growth hormone to patients with fibromyalgia who have low levels of insulin-like growth factor 1 resulted in improvement in their symptoms and tenderness. An association between chronic fatigue syndrome and initial infections was demonstrated. A correlation between particular immunologic abnormalities and measures of disease severity was documented in chronic fatigue syndrome. Concomitant fibromyalgia in other rheumatic diseases was a major contributor to poor quality of life. A favorable outcome of fibromyalgia in children was reported; the majority of patients improved over 2 to 3 years of follow-up. Treatment of patients with fibromyalgia continues to be of limited success.
mesh_terms: D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D005356:Fibromyalgia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009135:Muscular Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D009209:Myofascial Pain Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy