title: Assessing the prevalence of autoimmune, endocrine, gynecologic, and psychiatric comorbidities in an ethnically diverse cohort of female fibromyalgia patients: does the time from hysterectomy provide a clue?
abstract: BACKGROUND
  This retrospective chart review investigated differences in the prevalence of medical comorbidity between women with fibromyalgia (FM) (n=219) and a control group women with chronic pain (CP) without FM (n=116). The specific aims were to compare the prevalence of autoimmune, psychiatric, endocrine, gynecologic pathology, the relationship between timing of gynecologic surgery, and pain onset. We additionally sought to compare the number of comorbidities in an ethnically diverse cohort.
  
  
  METHODS
  This was a retrospective chart review of patients seen in FM or CP clinics at an academic medical center in 2009-2010.
  
  
  RESULTS
  Logistic regression modeling found that gynecologic, endocrine, and autoimmune diagnoses were independently associated with a diagnosis of FM. Detailed analyses showed that thyroid disease (P<0.01) and gynecologic surgery (P<0.05) were significantly more common in FM. Women with FM were more likely to have multiple autoimmune, endocrine, gynecologic, or psychiatric pathologies. A relationship was observed between the timing of gynecologic surgery and pain onset in FM, with more surgeries observed in the years just prior to pain onset or in the year after pain onset. A similar pattern was not found in the control group.
  
  
  CONCLUSIONS
  This study demonstrates that autoimmune, endocrine, and gynecologic pathologies occur more commonly in women with FM than in those with CP, which is consistent with findings in less ethnically diverse samples. Moreover, a relationship was found between timing of pain onset and gynecologic surgery. A larger prospective study of the relationship between gynecologic surgery and pain onset in FM is warranted.
authors: Department of Rehabilitation Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
authors: Larry
authors: L
authors: Brooks
authors: Anesco Interventional Pain Institute, Margate, FL, USA.
authors: Joseph
authors: J
authors: Hadi
authors: Department of Rehabilitation Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
authors: Kyle T
authors: KT
authors: Amber
authors: Miami Pain and Diagnostics, Miami, FL, USA.
authors: Michelle
authors: M
authors: Weiner
authors: Department of Psychiatry and Behavioral Health, Florida International University Wertheim College of Medicine, University Park, FL, USA.
authors: Christopher L
authors: CL
authors: La Riche
authors: Department of Rehabilitation Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
authors: Tamar
authors: T
authors: Ference
keywords: autoimmune; chronic pain; fibromyalgia; sex hormones; thyroid