De första tecknen på lupus kan se mycket ut som reumatoid artrit eller fibromyalgi. Vad du behöver veta

Fibromyalgi, lupus eller båda?


Upptäck hur din läkare kan skilja mellan fibromyalgi och lupus.


P: Min familjedoktor, misstänker att jag kanske har lupus, hänvisade mig till en reumatolog, som diagnostiserade fibromyalgi. Är det möjligt att få symptom på lupus, men har det verkligen fibromyalgi?

A: Att ta reda på om en patient har lupus, fibromyalgi eller båda – vilket är helt möjligt – kräver en grundlig medicinsk historia, fysisk undersökning och laboratorietester. Diagnosen av lupus och fibromyalgi kan vara svår eftersom villkoren delar några symtom.

Under sjukdomshistoria beskriver patienter med fibromyalgi ofta trötthet och generaliserad muskelsmärta eller muskelsmärta som ofta förvärras av brist på sömn. Lupuspatienter kan också ha trötthet och muskelsmärta, men de ursprungliga symptomen kan innehålla utslag på kinderna och näsan som förvärras med solljus, njureproblem, andfåddhet eller blodpropp, stroke eller hjärtinfarkt

Den fysiska undersökningen av en person med fibromyalgi visar leder som rör sig normalt och sväller inte. Emellertid har personer med fibromyalgi ofta mjuka områden på musklerna, och pressning av dessa områden orsakar obehag. Undersökning av en person med lupus kan avslöja ledsmärta, styvhet, svullnad eller onormal rörelse.

I de flesta fall leder patientens medicinska historia och fysisk undersökning till en diagnos; Laboratorietester bekräftar vanligtvis diagnosen. Ett blodtest som mäter nivån av antinukleära antikroppar (ANA) positiva människor vanligtvis med lupus, men kan också vara positiv i de med blandad bindvävssjukdom, reumatoid artrit (RA), sklerodermi och Sjögrens syndrom. Därför kommer en reumatolog att utföra flera andra speciella tester för att bekräfta lupus. Hos människor med fibromyalgi är alla blodprov vanligtvis normala.

En korrekt diagnos är viktigt eftersom behandlingar för lupus och fibromyalgi är olika. När en person har fibromyalgi och lupus, bör förskrivas kortikosteroider eller antireumatiska läkemedel sjukdom (DMARDs) såsom metotrexat, för att förhindra skador i samband med lupus på inre organ. Sjukgymnastik, rådgivning och antidepressiva läkemedel kan bidra till att förbättra muskelsmärta, sömn och humörsvängningar i samband med fibromyalgi.

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