Fibromiyalji ve Miyofasyal Ağrı Sendromlu Hastaların Nötrofil/Lenfosit Oranı, B12 Vitamin ve D Vitamin Düzeyleri Açısından Karşılaştırılması

GİRİŞ ve AMAÇ: Fibromiyalji(FMS) Ve Miyofasyal Ağrı Sendromuna (MAS) bağlı kronik ağrı nedeniyle başvuran hastalarda özellikle ayırıcı tanıya yardımcı olabilecek biyobelirteçleri karşılaştırmak. YÖNTEM ve GEREÇLER: Bu çalışma retrospektif olarak planlandı. Hastane hasta dosyaları incelenerek 105 FMS ve 109 MAS tanılı kadın hastanın tam kan sayımı testi, B12 vitamini (kobalamin) ve 25(OH) D vitamin değerleri karşılaştırıldı. BULGULAR: Gruplar arası karşılaştırmada 25(OH)D vitamini düzeylerinde istatistiksel olarak anlamlı fark varken diğer değişkenlere ait verilerde istatistiksel anlamlı fark yoktu. İki grup arasında 25(OH)D vitaminini eksiklik, yetersiz ve normal olarak kategorize edildiğinde istatistiksel olarak anlamlı fark saptanmadı. TARTIŞMA ve SONUÇ: FMS ve MAS yaygın görülen kas iskelet sistemi hastalıklarıdır. Çalışmamızda, laboratuvar parametrelerinde FMS ve MAS grupları arasında belirgin fark saptamadık. Diğer hastalıkları dışlamak için tetkikler yapılsa da tanıda koyma sürecinde ve iki hastalık arasında ayırıcı tanı yapmada bu tetkiklerin yetersiz kalabilmektedir.

Comparison of Neutrophil / Lymphocyte Ratio, Vitamin B12 and Vitamin D Levels in Patients With Fibromyalgia and Myofascial Pain Syndrome

INTRODUCTION: This study aimed to compare the biomarkers in patients presenting with chronic pain due to Fibromyalgia (FMS) and Myofascial Pain Syndrome (MAS), especially in differential diagnosis METHODS: : This study was planned as a retrospective study. The complete blood count test, vitamin B12 (cobalamin) and 25 (OH) D vitamin values of 105 patients with FMS and 109 MAS were compared. RESULTS: There was a statistically significant difference in 25 (OH) vitamin D in the comparison between the groups. When 25 (OH) vitamin D was deficient, inadequate and categorized as normal, no statistically significant difference was found. DISCUSSION AND CONCLUSION: FMS and MAS are common musculoskeletal disorders. In our study, we found no significant difference between FMS and MAS groups in laboratory parameters. Although examinations are performed to exclude other diseases, these tests may be insufficient in the diagnosis process and in making a differential diagnosis between the two diseases.

PDF

___

1. Treede R-D, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. A classification of chronic pain for ICD-11. Pain. 2015;156(6):1003- 1007. doi:10.1097/j.pain.0000000000000160.
2. Kim R. Observing the Effects of Mindfulness-Based Meditation on Anxiety and Depression in Chronic Pain Patients. International Journal of Psychology and Behavioral Sciences. 2015;5(4):143-147. doi:10.5923/j.ijpbs.20150504. 01.
3. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum. 1990;33(2):160–72.
4. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristic of fibromyalgia in the general population. Arthritis Rheum. 1995;38:19-28.
5. Topbaş M, Çakırbay H, Güleç H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20-64 in Turkey. Scand J Rheumatol. 2005; 34:140-144.
6. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600–10.
7. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RL, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016; 46(3):319- 329. doi: 10.1016/j.semarthrit.2016.08.012.
8. Wolfe F, Walitt B. Fibromyalgia is overdiagnosed in the general population. Arthritis Rheumatol. 2016; 68:3043–44.
9. Häuser W, Perrot S, Sommer C, Shir Y, Fitzcharles MA. Diagnostic confounders of chronic widespread pain: not always fibromyalgia. Pain Rep. 2017;2(3):e598. Published 2017 Apr 30. doi:10.1097/PR9.0000000000000598
10. Travell JG, Simons DG, Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore: Williams & Wilkins; 1999.
11. Bourgaize S, Newton G, Kumbhare D, Srbely J. A comparison of the clinical manifestation and pathophysiology of myofascial pain syndrome and fibromyalgia: implications for differential diagnosis and management. J Can Chiropr Assoc. 2018;62(1):26–41.
12. Varım C, Acar BA, Uyanık MS, Acar T, Alagoz N, et al. Association between the neutrophilto-lymphocyte ratio, a new marker of systemic inflammation, and restless legs syndrome. Singapore Med J. 2016;57(9):514-516.
13. Li J, Chen Q, Luo X, Hong J, Pan K, Lin X, et al. Neutrophil-to-Lymphocyte Ratio Positively Correlates to Age in Healthy Population. J Clin Lab Anal. 2015; 29(6): 437–443.
14. Sattar N, Welsh P, Panarelli M, Forouhi NG. Increasing requests for vitamin D measurement: costly, confusing, and without credibility. Lancet. 2012; 379(9811):95–6.
15. McBeth J, Pye SR, O'Neill TW, Macfarlane GJ, Tajar A, Bartfai G, et al. Musculoskeletal pain is associated with very low levels of vitamin D in men: results from the European male ageing study. Ann Rheum Dis. 2010;69(8):1448–52.
16. Karahan AY, Hüner B, Kuran B, Sezer N, Çelik C, Salbaş E, et al. Vitamin D Düzeyi ile Nonspesifik Kas İskelet Sistemi Ağrıları Arasındaki İlişkinin Değerlendirilmesi: Çok Merkezli Retrospektif Bir Çalışma (İnme Çalışma Grubu). Turk J Osteoporos. 2017;23:61-66.
17. Helde-Frankling M, Bjorkhem-Bergman L. Vitamin D in Pain Management. Int J Mol Sci. 2017;18(10):2170–8.
18. Okyay R, Koçyigit B, Gürsoy S. Vitamin D levels in women with fibromyalgia and relationship between pain, tender point count and disease activity. Acta Med Mediterr. 2016;32:243-7 doi:10.19193/0393-6384-2016-1-38.
19. Makrani AH, Afshari M, Ghajar M, Forooghi Z, Moosazadeh M. Vitamin D and fibromyalgia: a meta-analysis. Korean J Pain. 2017;30(4):250-7 doi:10.3344/kjp.2017.30.4.250
20. Geller M, Oliveira L, Nigri R, Mezitis SG, Ribeiro MG, et al. B Vitamins for Neuropathy and Neuropathic Pain. Vitam Miner. 2017;6:161. doi: 10.4172/2376-1318.1000161.
21. Aktürk, S. & Büyükavcı, R. Evaluation of blood neutrophil-lymphocyte ratio and platelet distribution width as inflammatory markers in patients with fibromyalgia Clin Rheumatol. 2017; 36: 1885. https://doi.org/10.1007/s10067-017-3647- 0.
22. Kösehasanoğulları, M, Yılmaz, N. Fibromiyalji Sendromu ve Nöropatik Ağrı. Ege Tıp Bilimleri Dergisi. 2018;1(1):26-31. Retrieved from http://dergipark.gov.tr/egetbd/issue/37116/434933.
23. Borg-Stein J, Iaccarino MA. Myofascial pain syndrome treatments. Phys Med Rehabil Clin N Am. 2014;25(2):357–374.
24. İlgün E, Akyürek Ö, Kalkan AO, Demir F, Demirayak M, Bilgi M. Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Fibromyalgia. European Journal of General Medicine. 2016;13(2):100-104. doi:10.15197/ ejgm.1525.
25. Zhang M, Han W, Hu S, Xu H Methylcobalamin: a potential vitamin of pain killer. Neural Plast. 2013:424651.
26. de Carvalho, J.F. & Silva, D.N.F. Serum levels of vitamin (cobalamin) in fibromyalgia Rheumatol Int 2016; 36: 741. https://doi.org/10.1007/s00296-016-3454-ysa.
27. Zhao S, Gardner K, Taylor W, Marks E, Goodson N. Vitamin D assessment in primary care: changing patterns of testing. London J Prim Care. 2015;7(2):15–22.
28. Ellis SD, Kelly ST, Shurlock JH, Hepburn Alastair LN. The role of vitamin D testing and replacement in fibromyalgia: a systematic literature review BMC Rheumatology. 2018: 2:28 https://doi.org/10.1186/s41927-018-0035-6.