BEWIJS VAN ZENUWSCHADE IN ONGEVEER DE HELFT VAN DE PATIËNTEN MET FIBROMYALGIE

Samenvatting: Ongeveer de helft van een kleine groep patiënten met fibromyalgie – een gemeenschappelijke syndroom dat chronische pijn en andere symptomen veroorzaakt – bleek schade aan zenuwvezels in de huid en andere tekenen van een ziekte die kleine vezels polyneuropathie (SFPN) hebben. In tegenstelling fibromyalgie, SFPN een duidelijke pathologie en bekend te worden veroorzaakt door specifieke medische aandoeningen, waarvan sommige kunnen worden behandeld en soms genezen.

aanverwant

Ongeveer de helft van een kleine groep patiënten met fibromyalgie – een gemeenschappelijke syndroom dat chronische pijn en andere symptomen veroorzaakt – bleek schade aan zenuwvezels in de huid en andere tekenen van een ziekte die kleine vezels polyneuropathie (SFPN) hebben. In tegenstelling tot fibromyalgie, die geen bekende oorzaken en weinig effectieve behandelingen heeft gehad, SFPN heeft een duidelijke pathologie en is bekend te worden veroorzaakt door specifieke medische aandoeningen, waarvan sommige kunnen worden behandeld en soms genezen. De studie van het Massachusetts General Hospital (MGH) onderzoekers zal verschijnen in het tijdschrift  PAIN  en is online vrijgegeven.

“Dit biedt een aantal van de eerste objectief bewijs van een mechanisme achter een aantal gevallen van fibromyalgie, en het identificeren van een onderliggende oorzaak is de eerste stap op weg naar het vinden van betere behandelingen,” zegt Anne Louise Oaklander, MD, PhD, directeur van het Nerve Injury Unit in de MGH Afdeling Neurologie en de bijbehorende auteur van het Pain papier.

De term fibromyalgie beschrijft een set van de symptomen – waaronder chronische wijdverspreide pijn, verhoogde gevoeligheid voor druk en vermoeidheid – die wordt verondersteld om bij 1 tot 5 procent van de mensen in de westerse landen, vaker vrouwen. Terwijl een diagnose van fibromyalgie is door de National Institutes of Health en de American College of Rheumatology is erkend, heeft haar biologische basis onbekend gebleven. Fibromyalgie aandelen vele symptomen met SFPN, een erkende oorzaak van chronische wijdverspreide pijn waarvoor worden geaccepteerd, objectieve tests.

Ontworpen om mogelijke verbindingen tussen de twee voorwaarden te onderzoeken, de huidige studie namen 27 volwassen patiënten met fibromyalgie diagnoses en 30 gezonde vrijwilligers. Deelnemers ging door een batterij van tests gebruikt SFPN diagnostiseren, inclusief beoordeling van neuropathie basis van een lichamelijk onderzoek en antwoorden op een vragenlijst huidbiopsieën het aantal zenuwvezels in de onderbenen evalueren en testen van autonome functies zoals hartslag , bloeddruk en zweten.

De vragenlijsten, examen assessments, en de huid biopten alle belangrijke niveaus van neuropathie in de fibromyalgie patiënten, maar niet in de controlegroep. Van de 27 patiënten met fibromyalgie, 13 had een duidelijke vermindering zenuwvezeldichtheid, abnormale autonome functietesten of beide, hetgeen de aanwezigheid van SFPN. Deelnemers die voldeden aan de criteria voor SFPN onderging ook bloedonderzoeken voor bekende oorzaken van de aandoening, en terwijl geen van hen de resultaten die wijzen op diabetes hadden, werden een veel voorkomende oorzaak van SFPN, twee gevonden om het hepatitis C virus infectie, die met succes kunnen worden behandeld hebben, en meer dan de helft had het bewijs van een soort van dysfunctie van het immuunsysteem.

“Tot nu toe is er geen goed idee over wat de oorzaak van fibromyalgie, maar nu hebben we bewijs voor een aantal, maar niet alle patiënten. Fibromyalgie is te complex voor een ‘one size fits all’ verklaring “, zegt Oaklander, een hoogleraar Neurologie aan de Harvard Medical School. “De volgende stap van het onafhankelijke bevestiging van onze bevindingen uit andere laboratoria gebeurt al, en we moeten ook die patiënten die niet voldeden aan SFPN criteria om te zien of we een andere oorzaak kunnen vinden volgen. Het helpen van een van deze mensen ontvangen definitieve diagnose en een betere behandeling zou een geweldige prestatie zijn.”

Story Bron:

materialen

verstrekt door  het Massachusetts General Hospital . Opmerking: Inhoud kan worden bewerkt voor stijl en lengte.

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