Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


The Prevalence of Fibromyalgia in Patients with Hereditary Hemochromatosis.

Mohammad1,  Ausaf, Carey4,  John J., Storan2,  Eoin R., Scarry2,  Margaret, Keane2,  Mary B., Moore2,  Angela, Lyons2,  Ann

Department of Hepatology and Rheumatology Galway University Hospital, Ireland
Galway University Hospital
Hepatology Galway University Hospital
Rheumatology Merlin Park University Hospital

Introduction:

Hereditary hemochromatosis (HH) is a well-defined syndrome characterized by the toxic accumulation of iron in parenchymal cells of liver, heart, and endocrine glands and is associated with inflammatory arthritis. Although studies have reported arthralgia and fatigue as common symptoms of this disorder little data exist of the presence of fibromyalgia syndrome (FMS) in this population.

Purpose:

In this study we assessed the prevalence of fibromyalgia in a cohort of subjects with HH and it's relationship to subject demographics, HH status, and quality of life.

Methods:

Cross-sectional study of a cohort of individuals with HH at our university hospital. Study was approved by local I.R.B. and all subjects gave informed consent. Patients with decompensated or concomitant autoimmune liver disease, arthritis, and vasculitis were excluded. All subjects underwent a single interview which included a fibromyalgia impact questionnaire, pain assessment measured on a 100-mm visual analogue scale (VAS) and disability assessment measured on the Stanford Health Assessment Questionnaire 20-Item Disability Scale (HAQ-DI) [10]. All patients underwent clinical examination by a trained physician which included assessment for arthritis and fibromyalgia tender points. Demographic data, details of HH and laboratory data including autoantibody profiles and iron studies were recorded from the patients' medical record.

Results:

350 patients with HH attending the hepatology unit consented to participate, 230 (66%) of whom were males with a mean age of 43 years (range 27–70). 170 (41%) subjects met criteria for the presence of FMS. In subjects with fibromyalgia, fatigue and >=11 tender points were present in all of the subjects, wide spread pain in 150 (88%), depression and arthralgia/ joint stiffness in 70 (41%). Among those with FMS mean pain score was 69 ± 10.25 and 33% reported some functional impairment on HAQ-DI (>0), with 10% reporting moderate-severe functional impairment (HAQ-DI >=1.5). Patients with fibromyalgia were more likely to be older, males with wide spread pain and history of depression, and had C282Y homozygosity in the HFE gene (table 1, p <0.005 for all categories).

Table 1. Comparing HH subjects with and without FMS

 Patients with FMS (n = 170)Patients without FMS (n = 180)p value
Male140 (82%)90 (50%)0.001
age >= 45 years90 (53%)50 (28%)0.001
Wide spread pain150 (88%)40 (22%)0.001
Depression70 (41%)30 (16%)0.001
C282Y Homozygous Genotype160 (94%)110 (61%)0.001

Conclusions:

There is a high prevalence of FMS (41%) among subjects with HH, one third of whom showed some degree of functional impairment.

To cite this abstract, please use the following information:
Mohammad, Ausaf, Carey, John J., Storan, Eoin R., Scarry, Margaret, Keane, Mary B., Moore, Angela, et al; The Prevalence of Fibromyalgia in Patients with Hereditary Hemochromatosis. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :818
DOI: 10.1002/art.28586

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