Fibromyalgia in 300 adult index patients with primary immunodeficiency.

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.

• Authors: James C Barton, Luigi F Bertoli, Jackson C Barton, Ronald T Acton
• Journal: Clinical and experimental rheumatology (Clin Exp Rheumatol) 2017 May-Jun Vol. 35 Suppl 105 Issue 3 Pg. 68-73 ISSN: 0392-856X [Print] Italy
• PMID: 28422000 (Publication Type: Journal Article)

Chemical References

• HLA-A Antigens
• HLA-A29 antigen
• HLA-B44 Antigen

Topics

• Adult
• Autoimmune Diseases (epidemiology)
• Common Variable Immunodeficiency (epidemiology, genetics)
• Cystitis, Interstitial (epidemiology)
• Fatigue Syndrome, Chronic (epidemiology)
• Female
• Fibromyalgia (epidemiology, genetics)
• HLA-A Antigens (genetics)
• HLA-B44 Antigen (genetics)
• Haplotypes
• Humans
• IgG Deficiency (epidemiology, genetics)
• Immunologic Deficiency Syndromes (epidemiology, genetics)
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Prevalence
• Retrospective Studies
• Sjogren's Syndrome (epidemiology)