Objectives: This study aims to determine the incidence of fibromyalgia (FM) in female patients with Behçet's disease (BD) and to investigate whether disease activity changes in the presence of FM in female patients with BD. Patients and methods: This cross-sectional study included 72 female patients with BD (mean age 39.7±10.5 years; range, 22 to 74 years) between June 2018 and February 2019. The frequency of FM was evaluated according to the American College of Rheumatology alternative criteria. Active clinical features and BD activity were evaluated with the Behçet's disease activity form (BDCAF). Results: The prevalence of FM was 29.2% in the BD patients. BD clinical activity index, patients’ perceptions of disease activity and clinicians' overall perceptions of disease activity scores were significantly higher in BD patients with FM (p=0.003, p
Vincent A, Lahr BD, Wolfe F, Clauw DJ, Whipple MO, Oh TH, et al. Prevalence of fibromyalgia: a population-based study in Olmsted County, Minnesota, utilizing the Rochester Epidemiology Project. Arthritis Care Res (Hoboken) 2013;65: 786-92.
Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995;38:19-28.
Jones GT, Atzeni F, Beasley M, Flüß E, Sarzi-Puttini P, Macfarlane GJ. The prevalence of fibromyalgia in the general population: a comparison of the American College of Rheumatology 1990, 2010, and modified 2010 classification criteria. Arthritis Rheumatol 2015;67:568-75.
Walitt B, Nahin RL, Katz RS, Bergman MJ, Wolfe F. The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey. PLoS One 2015;10:e0138024.
Wolfe F, Häuser W, Hassett AL, Katz RS, Walitt BT. The development of fibromyalgia--I: examination of rates and predictors in patients with rheumatoid arthritis (RA). Pain 2011;152:291-9.
Lee YC, Lu B, Boire G, Haraoui BP, Hitchon CA, Pope JE, et al. Incidence and predictors of secondary fibromyalgia in an early arthritis cohort. Ann Rheum Dis 2013;72:949-54.
Karaaslan Y, Oztürk M, Haznedaro¤lu S. Secondary fibromyalgia in Turkish patients with rheumatologic disorders. Lupus 1999;8:486.
Kadetoff D, Lampa J, Westman M, Andersson M, Kosek E. Evidence of central inflammation in fibromyalgia-increased cerebrospinal fluid interleukin-8 levels. J Neuroimmunol 2012;242:33-8.
Kosek E, Altawil R, Kadetoff D, Finn A, Westman M, Le Maître E, et al. Evidence of different mediators of central inflammation in dysfunctional and inflammatory pain--interleukin-8 in fibromyalgia and interleukin-1 b in rheumatoid arthritis. J Neuroimmunol 2015;280:49-55.
Mendieta D, De la Cruz-Aguilera DL, Barrera- Villalpando MI, Becerril-Villanueva E, Arreola R, Hernández-Ferreira E, et al. IL-8 and IL-6 primarily mediate the inflammatory response in fibromyalgia patients. J Neuroimmunol 2016;290:22-5.
Bote ME, García JJ, Hinchado MD, Ortega E. Inflammatory/stress feedback dysregulation in women with fibromyalgia. Neuroimmunomodulation 2012;19:343-51.
Imamura M, Targino RA, Hsing WT, Imamura S, Azevedo RS, Boas LS, et al. Concentration of cytokines in patients with osteoarthritis of the knee and fibromyalgia. Clin Interv Aging 2014;9:939-44.
Provan SA, Austad C, Halsaa V, Hammer HB, Kvien TK, Uhlig T. Fibromyalgia in patients with rheumatoid arthritis. A 10-year follow-up study, results from the Oslo Rheumatoid Arthritis Register. Clin Exp Rheumatol 2019;37:58-62.
Macfarlane GJ, Barnish MS, Pathan E, Martin KR, Haywood KL, Siebert S, et al. Co-Occurrence and Characteristics of Patients With Axial Spondyloarthritis Who Meet Criteria for Fibromyalgia: Results From a UK National Register. Arthritis Rheumatol 2017;69:2144-50.
Torrente-Segarra V, Corominas H, Sánchez-Piedra C, Fernández-Castro M, Andreu JL, Martínez- Taboada VM, et al. Fibromyalgia prevalence and associated factors in primary Sjögren's syndrome patients in a large cohort from the Spanish Society of Rheumatology registry (SJOGRENSER). Clin Exp Rheumatol 2017;35 Suppl 105:28-34.
Jobanputra C, Richey RH, Nair J, Moots RJ, Goebel A. Fibromyalgia in Behçet’s disease: a narrative review. Br J Pain 2017;11:97-101.
Melikoglu M, Melikoglu MA. The prevalence of fibromyalgia in patients with Behçet's disease and its relation with disease activity. Rheumatol Int 2013;33:1219-22.
Lee SS, Yoon HJ, Chang HK, Park KS. Fibromyalgia in Behçet's disease is associated with anxiety and depression, and not with disease activity. Clin Exp Rheumatol Clin Exp Rheumatol 2005;23(4 Suppl38):S15-9.
Haliloglu S, Carlioglu A, Akdeniz D, Karaaslan Y, Kosar A. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity. Rheumatol Int 2014;34:1275-80.
El-Rabbat M S, Mahmoud NK, Gheita TA. Clinical significance of fibromyalgia syndrome in different rheumatic diseases: Relation to disease activity and quality of life. Reumatol Clin 2018;14:285-9.
Yazici H, Tüzün Y, Pazarli H, Yurdakul S, Ozyazgan Y, Ozdo¤an H, et al. Influence of age of onset and patient's sex on the prevalence and severity of manifestations of Behçet's syndrome. Ann Rheum Dis 1984;43:783-9.
Bennett RM, Friend R, Marcus D, Bernstein C, Han BK, Yachoui R, et al. Criteria for the diagnosis of fibromyalgia: validation of the modified 2010 preliminary American College of Rheumatology criteria and the development of alternative criteria. Arthritis Care Res (Hoboken) 2014;66:1364-73.
Criteria for diagnosis of Behçet's disease. International Study Group for Behçet's Disease. Lancet 1990;335:1078-80.
Lawton G, Bhakta BB, Chamberlain MA, Tennant A. The Behcet's disease activity index. Rheumatology (Oxford) 2004;43:73-8.
Aloush V, Ablin JN, Reitblat T, Caspi D, Elkayam O. Fibromyalgia in women with ankylosing spondylitis. Rheumatol Int 2007;27:865-8.
Wolfe F, Michaud K. Severe rheumatoid arthritis (RA), worse outcomes, comorbid illness, and sociodemographic disadvantage characterize ra patients with fibromyalgia. J Rheumatol 2004;31:695-700.
Yavuz S, Fresko I, Hamuryudan V, Yurdakul S, Yazici H. Fibromyalgia in Behçet's syndrome. J Rheumatol 1998;25:2219-20.
Al-Izzi MK, Jabber AS. Fibromyalgia in Iraqi patients with Behcet's disease. J Med Liban 2004;52:86-90.
Uçeyler N, Häuser W, Sommer C. Systematic review with meta-analysis: cytokines in fibromyalgia syndrome. BMC Musculoskelet Disord 2011;12:245.
Hamzaoui K, Hamzaoui A, Guemira F, Bessioud M, Hamza M, Ayed K. Cytokine profile in Behçet's disease patients. Relationship with disease activity. Scand J Rheumatol 2002;31:205-10.
Ben Ahmed M, Houman H, Miled M, Dellagi K, Louzir H. Involvement of chemokines and Th1 cytokines in the pathogenesis of mucocutaneous lesions of Behçet's disease. Arthritis Rheum 2004;50:2291-5.
Sturgill J, McGee E, Menzies V. Unique cytokine signature in the plasma of patients with fibromyalgia. J Immunol Res 2014;2014:938576.
Raziuddin S, al-Dalaan A, Bahabri S, Siraj AK, al-Sedairy S. Divergent cytokine production profile in Behçet's disease. Altered Th1/Th2 cell cytokine pattern. J Rheumatol 1998;25:329-33.
Mantaş C, Direskeneli H, Ekşioglu-Demiralp E, Akoglu T. Serum levels of Th2 cytokines IL-4 and IL-10 in Behçet's disease. J Rheumatol. 1999;26:510-2.
Yazmalar L, Batmaz ‹, Sarıyıldız MA, Yıldız M, Uçmak D, Türkçü F, et al. Sleep quality in patients with Behçet's disease. Int J Rheum Dis. 2017;20:2062-9.
Lee J, Kim SS, Jeong HJ, Son CN, Kim JM, Cho YW, et al. Association of sleep quality in Behcet disease with disease activity, depression, and quality of life in Korean population. Korean J Intern Med 2017;32:352-9.
Clauw DJ. Fibromyalgia: a clinical review. JAMA 2014;311:1547-55.