EVIDÊNCIA DE DANO DO NERVO EM CERCA DE METADE DOS PACIENTES COM FIBROMIALGIA

Resumo: Cerca de metade de um pequeno grupo de pacientes com fibromialgia – um síndrome comum que causa a dor e outros sintomas – verificou-se ter danos para as fibras nervosas na sua pele e outras evidências de uma doença chamada de pequenas fibras polineuropatia (SFPN). Ao contrário de fibromialgia, SFPN tem uma patologia clara e é conhecida por ser causada por condições médicas específicas, algumas das quais podem ser tratados e, por vezes, curados.

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Cerca de metade de um pequeno grupo de pacientes com fibromialgia – um síndrome comum que causa a dor e outros sintomas – verificou-se ter danos para as fibras nervosas na sua pele e outras evidências de uma doença chamada de pequenas fibras polineuropatia (SFPN). Ao contrário de fibromialgia, que não teve nenhum causas conhecidas e poucos tratamentos eficazes, SFPN tem uma patologia clara e é conhecida por ser causada por condições médicas específicas, algumas das quais podem ser tratados e, por vezes, curados. O estudo do Massachusetts General Hospital (MGH) pesquisadores irão aparecer na revista  PAIN  e foi lançado online.

“Isso fornece algumas das primeiras evidências objetivas de um mecanismo por trás de alguns casos de fibromialgia, e identificando uma causa subjacente é o primeiro passo no sentido de encontrar melhores tratamentos”, diz Anne Louise Oaklander, MD, PhD, diretor da Unidade de ferimento do nervo no Departamento de MGH de Neurologia e autor correspondente do papel Pain.

O termo fibromialgia descreve um conjunto de sintomas – incluindo dor crônica generalizada, aumento da sensibilidade à pressão e fadiga – que é acreditado para afetar 1 a 5 por cento das pessoas nos países ocidentais, mais freqüentemente mulheres. Enquanto um diagnóstico de fibromialgia tem sido reconhecida pelos Institutos Nacionais de Saúde e da American College of Rheumatology, a sua base biológica permaneceu desconhecida. ações fibromialgia muitos sintomas com SFPN, uma reconhecida causa de dor crônica generalizada para os quais não são aceitos, testes objetivos.

Projetado para investigar possíveis conexões entre as duas condições, o presente estudo matriculados 27 pacientes adultos com diagnóstico de fibromialgia e 30 voluntários saudáveis. Os participantes passaram por uma bateria de testes usados ​​para diagnosticar SFPN, incluindo avaliações de neuropatia com base em um exame físico e respostas a um questionário, biópsias de pele para avaliar o número de fibras nervosas em suas pernas, e testes de funções autonômicas tais como frequência cardíaca , a pressão arterial e transpiração.

Os questionários, avaliações de exame, e biópsias de pele todos encontrados níveis significativos de neuropatia em pacientes com fibromialgia, mas não no grupo de controle. Dos 27 pacientes com fibromialgia, 13 tiveram uma redução marcada na densidade de fibras do nervo, testes da função autonômica anormais ou ambos, indicando a presença de SFPN. Os participantes que preencheram os critérios para SFPN também foram submetidos a testes de sangue para causas conhecidas da desordem, e enquanto nenhum deles teve resultados sugestivos de diabetes, uma causa comum de SFPN, dois foram encontrados a ter a infecção pelo vírus da hepatite C, que pode ser tratada com sucesso, e mais da metade tinha evidência de algum tipo de disfunção do sistema imunológico.

“Até agora, não houve nenhuma boa idéia sobre o que causa a fibromialgia, mas agora temos provas para alguns, mas nem todos os pacientes. A fibromialgia é demasiado complexo para um ‘one size fits all’ explicação “, diz Oaklander, um professor associado de Neurologia na Harvard Medical School. “O próximo passo de confirmação independente dos nossos resultados de outros laboratórios já está acontecendo, e nós também precisa seguir aqueles pacientes que não preencheram os critérios SFPN para ver se podemos encontrar outras causas. Ajudando qualquer uma dessas pessoas recebem diagnóstico definitivo e tratamento melhor seria uma grande realização.”

Fonte da história:

materiais

fornecida pelo  Hospital Geral de Massachusetts . Nota: O conteúdo pode ser editado para o estilo e comprimento.

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