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Query: UMLS:C0016053 (fibromyalgia)
 4,687 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Historically, arthritis was the main symptom which led to the description of the disease called Lyme borreliosis. However, a relatively high awareness of doctors and patients of tick-borne diseases seems to cause a trend to frequently diagnose this antibiotic-sensitive disease. A case can be defined as borreliosis only if either the typical erythema migrans is reliably identified by a physician or if a characteristic late manifestation of Lyme disease is accompanied by unequivocal serological and/or bacteriological evidence of Borrelia infection. Within the musculoskeletal system, the only reliably characteristic symptom is true synovitis, as defined by the palpable swelling of a joint. Mere joint pain or the subjective pain syndrome of fibromyalgia do not constitute a defining symptom for borreliosis. An evaluation of the frequency of Borrelia-associated arthritis in our Viennese rheumatology outpatient clinic revealed only six well-defined cases among 1,673 subsequent referrals. Based on "serological" suspicion, the question had been asked about possible borreliosis in 87 of these patients. In order to avoid unnecessary anxiety about possible long-term complications of Lyme disease among (actually misdiagnosed) patients, the diagnosis of Lyme arthritis should only be made according to the stringent criteria mentioned above. The antibiotic treatment, which is given to many questionable cases of borreliosis ex iuvantibus, although possibly of benefit to a few cases of otherwise undiagnosed reactive arthritis due to infections with microbes other than Borrelia burgdorferi, has to be termed irrational.
Infection
PMID:A "minority" opinion about the diagnosis and treatment of Lyme arthritis. 885 81

The aims of this study were: (1) to compare two groups of patients with chronic pain conditions (work-related muscular pain, mainly low back pain, and fibromyalgia) in general coping and pain-specific coping; (2) to examine the relationship between general and pain-specific coping and, (3) to examine the influence of state-trait anxiety on general and pain-specific coping. The sample included 80 individuals (range=19-70 years; mean=47; SD=9.9), who were patients at two pain management clinics for examination of their physical and psychosocial health conditions and consideration on disability pension. The patients were asked to respond to theStrategies to Handle Stress Questionnaire, theCoping Strategies Questionnaireand theState-Trait Anxiety Inventory. Patients with fibromyalgia scored significantly higher on T-anxiety and adopted <<problem-solving>> (p<0.01) and <<catharsis>> (p<0.05) less often and <<religion>> more often (p<0.01) than patients with work-related muscular pain in coping with stressful situations in general. No differences were revealed in pain-related coping between the groups. T-anxiety was positively correlated to pain-related <<catastrophizing>> (p<0.001) and negatively to abilities to control and reduce pain (p<0.05 andp<0.01, respectively). The correlation between general and pain-specific coping was weak to moderate. In conclusion, patients with fibromyalgia scored significantly higher on trait-anxiety and seem to interpret stressful situations as more threatening than patients with work-related muscular pain. Anxiety seems to be of central importance for coping with chronic pain. Anxiety-prone patients with fibromyalgia might benefit from psychological support in the process of coping with pain. Copyright 1998 The British Infection Society. All rights reserved.
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PMID:Anxiety and coping in patients with chronic work-related muscular pain and patients with fibromyalgia. 1070 Mar 26

Infection with B. burgdorferi can cause a large joint inflammatory arthritis in patients who have not been treated for early Lyme disease; the knee is the most common joint affected. The diagnosis depends on a history of known exposure to the spirochete, characteristic clinical features, and serologic studies (ELISA and Western blot) confirming exposure to the spirochete. In most patients, antibiotic therapy is curative, but in a smaller percentage of patients, the presence of the HLA-DR beta 1*0401 haplotype can trigger treatment-resistant arthritis, in which antibiotic therapy is ineffective; in these instances, remittive agents, such as hydroxychloroquine and methotrexate, are indicated. Arthroscopic synovectomy may be considered when antibiotic therapy is not curative. Fibromyalgia can follow infection with B. burgdorferi but is unresponsive to antibiotic therapy; it is treated with tricyclic antidepressants and an exercise program. Lyme arthritis is the only chronic inflammatory arthritis in which the specific cause is known and can be cured. As such, it serves as an excellent model with which to study the pathogenesis of more common inflammatory arthritides, such as rheumatoid arthritis.
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PMID:Lyme arthritis. 1198 3

The etiology and pathogenesis of certain types of disease remain controversial and stand like a bridge that crosses infectious, autoimmune and autoinflammatory pathways. Infection, for example, may initiate a disease, although it is the genetic regulation in the host, the interplay between virus or bacteria persistence and autoimmunity that produces the later phases of disease, the antigenic determinants responsible for inducing autoimmune disease, and the pathogenetic effector mechanisms. Infections agents cause pericarditis, but in 85% of cases it is "idiopathic". It has also been shown that persistent Clamydia pneumoniae, Porphyromonas gingivalis, and Helicobacter pylori infections cause host immunity and promote atherogenesis. A number of infectious agents have been suggested as potential triggers for primary biliary cirrhosis. Infections and vaccinations have also been linked to the pathogenesis of fibromyalgia syndrome, a common, chronic syndrome of widespread pain. Many factors are also responsible for fever of unknown origin such as: infections, autoimmunity disease, etc. However, it is difficult to determine a direct correlation between the infections agents in such a large group of diseases. The aim of this review is to analyze some of the controversies about the role of infections in autoimmune diseases.
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PMID:Autoimmune diseases and infections: controversial issues. 1857 Jul 58