title: Inflammatory Fibromyalgia: Is it Real?
abstract: Fibromyalgia (FM) is a characterized by generalized pain with widespread tender points in specific areas and is frequently accompanied by fatigue, stiffness, and a non-restorative sleep pattern. In the current retrospective study, we identified a subgroup of FM patients who had clinically important markers of inflammation. The study also explored the use of the original American College of Rheumatology (ACR) criteria in the diagnosis of FM. Our data suggested there was a distinct subset of patients with FM who had positive ESR, CRP, ANA and RF; a group that we considered representative of inflammatory FM. None of the FM patients in this study developed a documented coexisting autoimmune illness during the retrospective review period. The existence of FM subgroups further puts into question the already controversial use of either the new or old ACR classification criteria in the diagnosis of FM, as they do not address the issue of systemic inflammation which appears to be significant.
authors.affiliation: Clinical Professor of rheumatology at USC. 150 N 3<sup>rd</sup> ave, Covina, Ca 91723, USA.
authors.forename: Samy K
authors.initials: SK
authors.lastname: Metyas
authors.forename: John S
authors.initials: JS
authors.lastname: Solyman
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Arkfeld
keywords: ACR; autoimmune; diagnosis; inflammatory markers