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Fibromyalgia and chronic widespread pain in autoimmune thyroid disease

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Abstract

Fibromyalgia and chronic widespread pain syndromes are among the commonest diseases seen in rheumatology practice. Despite advances in the management of these conditions, they remain significant causes of morbidity and disability. Autoimmune thyroid disease is the most prevalent autoimmune disorder, affecting about 10 % of the population, and is a recognized cause of fibromyalgia and chronic widespread pain. Recent reports are shedding light on the mechanisms of pain generation in autoimmune thyroid disease-associated pain syndromes including the role of inflammatory mediators, small-fiber polyneuropathy, and central sensitization. The gradual elucidation of these pain pathways is allowing the rational use of pharmacotherapy in the management of chronic widespread pain in autoimmune thyroid disease. This review looks at the current understanding of the prevalence of pain syndromes in autoimmune thyroid disease, their likely causes, present appreciation of the pathogenesis of chronic widespread pain, and how our knowledge can be used to find lasting and effective treatments for the pain syndromes associated with autoimmune thyroid disease.

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References

  1. Vanhoof J, Declerck K, Geusens P (2002) Prevalence of rheumatic diseases in a rheumatological outpatient practice. Ann Rheum Dis 61:453–455

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Branco JC, Bannwarth B, Failde I et al (2010) Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum 39:448–453

    Article  PubMed  Google Scholar 

  3. Schaefer C, Chandran A, Hufstader M et al (2011) The comparative burden of mild, moderate and severe fibromyalgia: results from a cross-sectional survey in the United States. Health Qual Life Outcomes 9:71

    Article  PubMed Central  PubMed  Google Scholar 

  4. Spaeth M (2009) Epidemiology, costs, and the economic burden of fibromyalgia. Arthritis Res Ther 11:117

    Article  PubMed Central  PubMed  Google Scholar 

  5. Howard KJ, Mayer TG, Neblett R, Perez Y, Cohen H, Gatchel RJ (2010) Fibromyalgia syndrome in chronic disabling occupational musculoskeletal disorders: prevalence, risk factors, and posttreatment outcomes. J Occup Environ Med 52:1186–1191

    Article  PubMed  Google Scholar 

  6. Stathatos N, Daniels GH (2012) Autoimmune thyroid disease. Curr Opin Rheumatol 24:70–75

    Article  CAS  PubMed  Google Scholar 

  7. Weetman AP (2003) Autoimmune thyroid disease: propagation and progression. Eur J Endocrinol 148:1–9

    Article  CAS  PubMed  Google Scholar 

  8. Czarnocka B (2011) Thyroperoxidase, thyroglobulin, Na(+)/I(−) symporter, pendrin in thyroid autoimmunity. Front Biosci (Landmark Ed) 16:783–802

    Article  CAS  Google Scholar 

  9. Pearce EN, Farwell AP, Braverman LE (2003) Thyroiditis. N Engl J Med 348:2646–2655

    Article  PubMed  Google Scholar 

  10. Carette S, Lefrancois L (1988) Fibrositis and primary hypothyroidism. J Rheumatol 15:1418–1421

    CAS  PubMed  Google Scholar 

  11. Kato K, Sullivan PF, Evengard B, Pedersen NL (2006) Chronic widespread pain and its comorbidities: a population-based study. Arch Intern Med 166:1649–1654

    Article  PubMed  Google Scholar 

  12. Becker KL, Ferguson RH, Mc CW (1963) The connective-tissue diseases and symptoms associated with Hashimoto’s thyroiditis. N Engl J Med 268:277–280

    Article  CAS  PubMed  Google Scholar 

  13. Golding DN (1970) Hypothyroidism presenting with musculoskeletal symptoms. Ann Rheum Dis 29:10–14

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Wilke WS, Sheeler LR, Makarowski WS (1981) Hypothyroidism with presenting symptoms of fibrositis. J Rheumatol 8:626–631

    CAS  PubMed  Google Scholar 

  15. Bland JH, Frymoyer JW, Newberg AH, Revers R, Norman RJ (1979) Rheumatic syndromes in endocrine disease. Semin Arthritis Rheum 9:23–65

    Article  CAS  PubMed  Google Scholar 

  16. Gillan MM, Scofield RH, Harley JB (2002) Hashimoto’s thyroiditis presenting as bilateral knee arthropathy. J Okla State Med Assoc 95:323–325

    PubMed  Google Scholar 

  17. Kloppenburg M, Dijkmans BA, Rasker JJ (1993) Effect of therapy for thyroid dysfunction on musculoskeletal symptoms. Clin Rheumatol 12:341–345

    Article  CAS  PubMed  Google Scholar 

  18. Golding DN (1993) Rheumatism and the thyroid. J R Soc Med 86:130–132

    CAS  PubMed Central  PubMed  Google Scholar 

  19. Aarflot T, Bruusgaard D (1996) Association between chronic widespread musculoskeletal complaints and thyroid autoimmunity. Results from a community survey. Scand J Prim Health Care 14:111–115

    Article  CAS  PubMed  Google Scholar 

  20. Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33:160–172

    Article  CAS  PubMed  Google Scholar 

  21. Bazzichi L, Rossi A, Giuliano T et al (2007) Association between thyroid autoimmunity and fibromyalgic disease severity. Clin Rheumatol 26:2115–2120

    Article  PubMed  Google Scholar 

  22. Bazzichi L, Rossi A, Zirafa C et al (2012) Thyroid autoimmunity may represent a predisposition for the development of fibromyalgia? Rheumatol Int 32:335–341

    Article  CAS  PubMed  Google Scholar 

  23. Pamuk ON, Cakir N (2007) The frequency of thyroid antibodies in fibromyalgia patients and their relationship with symptoms. Clin Rheumatol 26:55–59

    Article  PubMed  Google Scholar 

  24. Suk JH, Lee JH, Kim JM (2012) Association between thyroid autoimmunity and fibromyalgia. Exp Clin Endocrinol Diabetes 120:401–404

    Article  CAS  PubMed  Google Scholar 

  25. Ribeiro LS, Proietti FA (2004) Interrelations between fibromyalgia, thyroid autoantibodies, and depression. J Rheumatol 31:2036–2040

    PubMed  Google Scholar 

  26. Wolfe F, Brahler E, Hinz A, Hauser W (2013) Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: results from a survey of the general population. Arthritis Care Res (Hoboken) 65:777–785

    Article  Google Scholar 

  27. Soy M, Guldiken S, Arikan E, Altun BU, Tugrul A (2007) Frequency of rheumatic diseases in patients with autoimmune thyroid disease. Rheumatol Int 27:575–577

    Article  PubMed  Google Scholar 

  28. Tagoe CE, Zezon A, Khattri S, Castellanos P (2013) Rheumatic manifestations of euthyroid, anti-thyroid antibody-positive patients. Rheumatol Int 33:1745–1752

    Article  CAS  PubMed  Google Scholar 

  29. Biro E, Szekanecz Z, Czirjak L et al (2006) Association of systemic and thyroid autoimmune diseases. Clin Rheumatol 25:240–245

    Article  PubMed  Google Scholar 

  30. Boelaert K, Newby PR, Simmonds MJ et al (2010) Prevalence and relative risk of other autoimmune diseases in subjects with autoimmune thyroid disease. Am J Med 123:183, e1-9

    Article  PubMed  Google Scholar 

  31. Cho JH, Gregersen PK (2011) Genomics and the multifactorial nature of human autoimmune disease. N Engl J Med 365:1612–1623

    Article  CAS  PubMed  Google Scholar 

  32. Lazurova I, Benhatchi K, Rovensky J et al (2009) Autoimmune thyroid disease and autoimmune rheumatic disorders: a two-sided analysis. Ann N Y Acad Sci 1173:211–216

    Article  CAS  PubMed  Google Scholar 

  33. Buskila D, Sarzi-Puttini P (2008) Fibromyalgia and autoimmune diseases: the pain behind autoimmunity. Isr Med Assoc J 10:77–78

    PubMed  Google Scholar 

  34. Koroschetz J, Rehm SE, Gockel U et al (2011) Fibromyalgia and neuropathic pain—differences and similarities. A comparison of 3,057 patients with diabetic painful neuropathy and fibromyalgia. BMC Neurol 11:55

    Article  PubMed Central  PubMed  Google Scholar 

  35. Oaklander AL, Herzog ZD, Downs HM, Klein MM (2013) Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia. Pain

  36. Orstavik K, Norheim I, Jorum E (2006) Pain and small-fiber neuropathy in patients with hypothyroidism. Neurology 67:786–791

    Article  PubMed  Google Scholar 

  37. Molina F, Bouanani M, Pau B, Granier C (1996) Characterization of the type-1 repeat from thyroglobulin, a cysteine-rich module found in proteins from different families. Eur J Biochem 240:125–133

    Article  CAS  PubMed  Google Scholar 

  38. Malthiery Y, Marriq C, Berge-Lefranc JL et al (1989) Thyroglobulin structure and function: recent advances. Biochimie 71:195–209

    Article  CAS  PubMed  Google Scholar 

  39. Mori N, Itoh N, Salvaterra PM (1987) Evolutionary origin of cholinergic macromolecules and thyroglobulin. Proc Natl Acad Sci U S A 84:2813–2817

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  40. Weetman AP, Tse CK, Randall WR, Tsim KW, Barnard EA (1988) Acetylcholinesterase antibodies and thyroid autoimmunity. Clin Exp Immunol 71:96–99

    CAS  PubMed Central  PubMed  Google Scholar 

  41. Desmeules JA, Cedraschi C, Rapiti E et al (2003) Neurophysiologic evidence for a central sensitization in patients with fibromyalgia. Arthritis Rheum 48:1420–1429

    Article  CAS  PubMed  Google Scholar 

  42. Watkins LR, Milligan ED, Maier SF (2001) Glial activation: a driving force for pathological pain. Trends Neurosci 24:450–455

    Article  CAS  PubMed  Google Scholar 

  43. Watkins LR, Maier SF (2005) Immune regulation of central nervous system functions: from sickness responses to pathological pain. J Intern Med 257:139–155

    Article  CAS  PubMed  Google Scholar 

  44. Bellato E, Marini E, Castoldi F et al (2012) Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat 2012:426130

    PubMed Central  PubMed  Google Scholar 

  45. Mohacsik P, Zeold A, Bianco AC, Gereben B (2011) Thyroid hormone and the neuroglia: both source and target. J Thyroid Res 2011:215718

    Article  PubMed Central  PubMed  Google Scholar 

  46. Martinez-Lavin M (2013) Small fibre neuropathy, fibromyalgia and dorsal root ganglia sodium channels. Brain 136:e246

    Article  PubMed  Google Scholar 

  47. Kawakami M, Tamaki T, Matsumoto T, Kuribayashi K, Takenaka T, Shinozaki M (2000) Role of leukocytes in radicular pain secondary to herniated nucleus pulposus. Clin Orthop Relat Res 268–277

  48. Podolecki T, Podolecki A, Hrycek A (2009) Fibromyalgia: pathogenetic, diagnostic and therapeutic concerns. Pol Arch Med Wewn 119:157–161

    PubMed  Google Scholar 

  49. Kidd BL, Urban LA (2001) Mechanisms of inflammatory pain. Br J Anaesth 87:3–11

    Article  CAS  PubMed  Google Scholar 

  50. Tagoe CE, Zezon A, Khattri S (2012) Rheumatic manifestations of autoimmune thyroid disease: the other autoimmune disease. J Rheumatol 39:1125–1129

    Article  CAS  PubMed  Google Scholar 

  51. Lee YC (2013) Effect and treatment of chronic pain in inflammatory arthritis. Curr Rheumatol Rep 15:300

    Article  PubMed Central  PubMed  Google Scholar 

  52. Xiao Y, Haynes WL, Michalek JE, Russell IJ (2013) Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syndrome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate. Rheumatol Int 33:1259–1264

    Article  CAS  PubMed  Google Scholar 

  53. Kaklamanos M, Thomas D, Pikazis D, Christaki S, Kaltsas G (2013) The effect of rituximab on thyroid function and autoimmunity. Thyroid 23:1044–1045

    Article  CAS  PubMed  Google Scholar 

  54. Raterman HG, Jamnitski A, Lems WF et al (2011) Improvement of thyroid function in hypothyroid patients with rheumatoid arthritis after 6 months of adalimumab treatment: a pilot study. J Rheumatol 38:247–251

    Article  CAS  PubMed  Google Scholar 

  55. Atzeni F, Doria A, Ghirardello A et al (2008) Organ-specific autoantibodies in patients with rheumatoid arthritis treated with adalimumab: a prospective long-term follow-up. Autoimmunity 41:87–91

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Geriatrics, Albert Einstein College of Medicine, Bronx, NY, USA

    Jowairiyya Ahmad

  2. Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA

    Clement E. Tagoe

  3. Division of Rheumatology, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467-2490, USA

    Clement E. Tagoe

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  1. Jowairiyya Ahmad
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  2. Clement E. Tagoe
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Correspondence to Clement E. Tagoe.

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Ahmad, J., Tagoe, C.E. Fibromyalgia and chronic widespread pain in autoimmune thyroid disease. Clin Rheumatol 33, 885–891 (2014). https://doi.org/10.1007/s10067-014-2490-9

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  • DOI: https://doi.org/10.1007/s10067-014-2490-9

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