Fibromyalgia syndrome among iraqi patients with multiple sclerosis

Objective: To study the relationship between fibromyalgia syndrome (FMS) and relapsing remitting multiple sclerosis (RRMS) in Iraqi patients. Patients and Methods: The two stages classification process proposed by the l990 American College of Rheumatology (ACR) multicenter criteria committee of FMS was applied after an objective assessment of multiple sclerosis (MS) patients and control group about full history and complete clinical examination. Stage I: A pain questionnaire was given to a sample of 140 (97 female and 43 male) consecutive patient with RRMS mean age 37.1 years (range 17-60 years) who were attending MS clinic in Baghdad Teaching Hospital. Stage II: All patients with chronic wide spread pain (CWP) where examined by the same examiner for 18 tender points. Another 140 healthy individuals matched for age and sex were examined as controls. Results: CWP was present in 83 of 140 (59.3%) RRMS patient compared to only 34 (24.3%) individual in the control group (P= 0.000). FMS was present in 20 of 140 (14.3%) RRMS patients by the 1990 ACR criteria as compared to only 6 (4.3%) individuals in the control group (P= 0.007). Female patients with RRMS have high percentage of CWP and FMS compared to male patients in the study group. There were positive correlations between FMS and RRMS patients with regards to age (P= 0.028), disease duration of more than five years (P= 0.000) and number of relapse attacks (P= 0.000) but no significant relation with Expanded disability status score (EDSS) or Body mass index (BMI). Conclusions: Chronic wide spread pain (CWP) and fibromyalgia syndrome (FMS) are positively correlated with Relapsing Remitting multiple sclerosis (RRMS) when compared with control group. FMS is more common in female patients who had disease duration ≥ 5 years with more disability status. Relapsing remitting multiple sclerosis having FMS showed more relapse attacks compared to those without FMS.