Environ la moitié d’un petit groupe de patients souffrant de fibromyalgie – un syndrome commun qui provoque des douleurs chroniques et d’autres symptômes – a été constaté que les dommages aux fibres nerveuses de la peau et d’autres preuves d’une maladie polyneuropathie appelée petite fibre (SFPN). Contrairement à la fibromyalgie, qui n’a pas eu de causes connues et peu de traitements efficaces, SFPN a une pathologie claire et est connue pour être provoquée par des conditions médicales spécifiques, dont certaines peuvent être traitées et parfois guéries. L’étude du Massachusetts chercheurs General Hospital (MGH) apparaît dans la revue Pain et a été publié en ligne.
« Cela donne une partie de la première preuve objective d’un mécanisme derrière certains cas de la fibromyalgie et l’identification d’une cause sous-jacente est la première étape en vue de trouver de meilleurs traitements », explique Anne Louise Oaklander, MD, PhD, directeur de l’unité de nerf des blessures dans le MGH Département de neurologie et auteur du papier douleur.
Le terme fibromyalgie décrit un ensemble de symptômes – y compris la douleur chronique généralisée, une sensibilité accrue à la pression et la fatigue – qui est censé affecter 1 à 5 pour cent des personnes dans les pays occidentaux, les femmes plus fréquemment. Même si un diagnostic de fibromyalgie a été reconnu par les National Institutes of Health et l’American College of Rheumatology, la base biologique est restée inconnue. actions Fibromyalgie nombreux symptômes avec SFPN, une cause reconnue de la douleur chronique généralisée pour laquelle sont acceptés, les tests objectifs.
Conçu pour enquêter sur les liens possibles entre les deux conditions, l’étude inscrit 27 patients adultes ayant reçu un diagnostic de fibromyalgie et 30 volontaires en bonne santé. Les participants sont passés par une batterie de tests utilisés pour diagnostiquer SFPN, y compris les évaluations de la neuropathie basée sur un examen physique et des réponses à un questionnaire, les biopsies de la peau pour évaluer le nombre de fibres nerveuses dans leurs jambes, et des tests de fonctions autonomes telles que la fréquence cardiaque , le sang transpiration pressureand.
Les questionnaires, les évaluations des examens et des biopsies de la peau ont tous trouvé des niveaux significatifs de la neuropathie chez les patients atteints de fibromyalgie, mais pas dans le groupe témoin. Sur les 27 patients atteints de fibromyalgie, 13 avaient une réduction marquée de la densité des fibres nerveuses, des tests de la fonction autonome anormales ou les deux, ce qui indique la présence de SFPN. Les participants qui répondaient aux critères pour SFPN ont également subi des tests sanguins pour des causes connues de la maladie, et alors qu’aucun d’entre eux a eu des résultats évocateurs du diabète, une cause fréquente de SFPN, deux se sont avérés être infectés par le virus de l’hépatite C, qui peut être traitée avec succès, et plus de la moitié présentaient des signes d’un certain type de dysfonctionnement du système immunitaire.
« Jusqu’à présent, il n’y a pas eu une bonne idée de ce qui cause la fibromyalgie, mais maintenant nous avons des preuves pour certains, mais pas tous les patients. La fibromyalgie est trop complexe pour une « taille unique » explication », dit Oaklander, professeur agrégé de neurologie à la Harvard Medical School. « La prochaine étape de confirmation indépendante de nos résultats d’autres laboratoires est déjà le cas, et nous avons aussi besoin de suivre les patients qui ne répondaient pas aux critères SFPN pour voir si nous pouvons trouver d’autres causes. Aider l’une de ces personnes reçoivent des diagnostics et un meilleur traitement serait une grande réussite.
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