Skip to main content

Advertisement

Log in

Functional somatic syndrome: how it could be relevant to rheumatologists

  • REVIEW ARTICLE
  • Published:
Modern Rheumatology

Abstract

Functional somatic syndrome (FSS) is defined as a group of related syndromes characterized more by symptoms, suffering, and disability than by structural or functional abnormality. The diagnostic criteria and/or symptoms of FSS often overlap, and co-morbidity is commonly found among the diseases of FSS. For example, patients with irritable bowel syndrome often suffer from chronic pain, and a high percentage of co-morbidity can be found with fibromyalgia. Accumulating evidence indicates the presence of visceral and somatic hyperalgesia in FSS as a common feature, and the central sensitization mechanism has been suggested to play an important role in the pathophysiology of FSS. In the present article, the authors introduce the concept of FSS focusing on its possible relevance to rheumatology in terms of pain perception. A possible implication of mast cells and proteinase-activated receptor-2 (PAR-2) in FSS is also reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. S Wessely C Nimnuan M Sharpe (1999) ArticleTitleFunctional somatic syndromes: one or many? Lancet 354 IssueID9182 936–9 Occurrence Handle10489969 Occurrence Handle10.1016/S0140-6736(98)08320-2 Occurrence Handle1:STN:280:DyaK1MvhvVGjsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  2. A Barsky J Borus (1999) ArticleTitleFunctional somatic syndrome Ann Intern Med 130 910–21 Occurrence Handle10375340 Occurrence Handle1:STN:280:DyaK1M3ps1WjsA%3D%3D

    PubMed  CAS  Google Scholar 

  3. M Sharpe A Carson (2001) ArticleTitle“Unexplained” somatic symptoms, functional syndromes, and somatization: do we need a paradigm shift? Ann Intern Med 134 IssueID9 Pt 2 926–30 Occurrence Handle11346330 Occurrence Handle1:STN:280:DC%2BD3M3lsFWnuw%3D%3D

    PubMed  CAS  Google Scholar 

  4. WG Thompson GF Longstreth DA Drossman KW Heaton EJ Irvine SA Muller-Lissner (1999) ArticleTitleFunctional bowel disorders and functional abdominal pain Gut 45 Suppl 2 II43–7 Occurrence Handle10457044 Occurrence Handle1:STN:280:DyaK1MzovVShtg%3D%3D Occurrence Handle10.1136/gut.45.2008.ii43

    Article  PubMed  CAS  Google Scholar 

  5. B Van Houdenhove UT Egle (2004) ArticleTitleFibromyalgia: a stress disorder? Piecing the biopsychosocial puzzle together Psychother Psychosom 73 IssueID5 267–75 Occurrence Handle15292624 Occurrence Handle10.1159/000078843

    Article  PubMed  Google Scholar 

  6. A Scott A Mihailidou R Smith J Kellow M Jones C Lorang et al. (1993) ArticleTitleFunctional gastrointestinal disorders in unselected patients with non-cardiac chest pain Scand J Gastroenterol 28 IssueID7 585–90 Occurrence Handle8362209 Occurrence Handle1:STN:280:DyaK3szmvFGhtw%3D%3D

    PubMed  CAS  Google Scholar 

  7. M Meeus J Nijs KD Meirleir (2006) ArticleTitleChronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review Eur J Pain 11 377–386 Occurrence Handle16843021 Occurrence Handle10.1016/j.ejpain.2006.06.005

    Article  PubMed  Google Scholar 

  8. K Fukuda SE Straus I Hickie MC Sharpe JG Dobbins A Komaroff (1994) ArticleTitleThe chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group Ann Intern Med 121 IssueID12 953–9 Occurrence Handle7978722 Occurrence Handle1:STN:280:DyaK2M%2FmvFCiug%3D%3D

    PubMed  CAS  Google Scholar 

  9. LJ Crofford (1998) ArticleTitleThe hypothalamic-pituitary-adrenal stress axis in fibromyalgia and chronic fatigue syndrome Z Rheumatol 57 Suppl 2 67–71 Occurrence Handle10025087 Occurrence Handle10.1007/s003930050239 Occurrence Handle1:STN:280:DyaK1M7kvFahtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. MA Demitrack LJ Crofford (1998) ArticleTitleEvidence for and pathophysiologic implications of hypothalamic-pituitary-adrenal axis dysregulation in fibromyalgia and chronic fatigue syndrome Ann N Y Acad Sci 840 684–97 Occurrence Handle9629295 Occurrence Handle10.1111/j.1749-6632.1998.tb09607.x Occurrence Handle1:STN:280:DyaK1c3pt12nsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  11. G Neeck LJ Crofford (2000) ArticleTitleNeuroendocrine perturbations in fibromyalgia and chronic fatigue syndrome Rheum Dis Clin North Am 26 IssueID4 989–1002 Occurrence Handle11084955 Occurrence Handle10.1016/S0889-857X(05)70180-0 Occurrence Handle1:STN:280:DC%2BD3M7hvF2isQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  12. J Gaab D Huster R Peisen V Engert V Heitz T Schad et al. (2002) ArticleTitleHypothalamic-pituitary-adrenal axis reactivity in chronic fatigue syndrome and health under psychological, physiological, and pharmacological stimulation Psychosom Med 64 IssueID6 951–62 Occurrence Handle12461200 Occurrence Handle10.1097/01.PSY.0000038937.67401.61 Occurrence Handle1:CAS:528:DC%2BD38XovVektbo%3D

    Article  PubMed  CAS  Google Scholar 

  13. LA Bradley NL McKendree-Smith GS Alarcon (2000) ArticleTitlePain complaints in patients with fibromyalgia versus chronic fatigue syndrome Curr Rev Pain 4 IssueID2 148–57 Occurrence Handle10998728 Occurrence Handle1:STN:280:DC%2BD3MvjsVelsA%3D%3D

    PubMed  CAS  Google Scholar 

  14. JB Prins JW van der Meer G Bleijenberg (2006) ArticleTitleChronic fatigue syndrome Lancet 367 IssueID9507 346–55 Occurrence Handle16443043 Occurrence Handle10.1016/S0140-6736(06)68073-2

    Article  PubMed  Google Scholar 

  15. HJ Cho A Skowera A Cleare S Wessely (2006) ArticleTitleChronic fatigue syndrome: an update focusing on phenomenology and pathophysiology Curr Opin Psychiatry 19 IssueID1 67–73 Occurrence Handle16612182 Occurrence Handle10.1097/01.yco.0000194370.40062.b0

    Article  PubMed  Google Scholar 

  16. AJ Parker S Wessely AJ Cleare (2001) ArticleTitleThe neuroendocrinology of chronic fatigue syndrome and fibromyalgia Psychol Med 31 IssueID8 1331–45 Occurrence Handle11722149 Occurrence Handle1:STN:280:DC%2BD3MnnsFyktA%3D%3D Occurrence Handle10.1017/S0033291701004664

    Article  PubMed  CAS  Google Scholar 

  17. AJ Cleare (2003) ArticleTitleThe neuroendocrinology of chronic fatigue syndrome Endocr Rev 24 IssueID2 236–52 Occurrence Handle12700181 Occurrence Handle1:CAS:528:DC%2BD3sXjsFyltLs%3D

    PubMed  CAS  Google Scholar 

  18. WJ Inder TC Prickett RT Mulder (2005) ArticleTitleNormal opioid tone and hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome despite marked functional impairment Clin Endocrinol (Oxf) 62 IssueID3 343–8 Occurrence Handle10.1111/j.1365-2265.2005.02220.x Occurrence Handle1:CAS:528:DC%2BD2MXjtVersLY%3D

    Article  CAS  Google Scholar 

  19. SF Bomholt JD Mikkelsen G Blackburn-Munro (2005) ArticleTitleNormal hypothalamo-pituitary-adrenal axis function in a rat model of peripheral neuropathic pain Brain Res 1044 IssueID2 216–26 Occurrence Handle15885220 Occurrence Handle10.1016/j.brainres.2005.03.005 Occurrence Handle1:CAS:528:DC%2BD2MXktVOgtrc%3D

    Article  PubMed  CAS  Google Scholar 

  20. D Veale G Kavanagh JF Fielding O Fitzgerald (1991) ArticleTitlePrimary fibromyalgia and the irritable bowel syndrome: different expressions of a common pathogenetic process Br J Rheumatol 30 IssueID3 220–2 Occurrence Handle2049586 Occurrence Handle10.1093/rheumatology/30.3.220 Occurrence Handle1:STN:280:DyaK3M3msF2ksQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  21. JA Cole KJ Rothman HJ Cabral Y Zhang FA Farraye (2006) ArticleTitleMigraine, fibromyalgia, and depression among people with IBS: a prevalence study BMC Gastroenterol 6 26 Occurrence Handle17007634 Occurrence Handle10.1186/1471-230X-6-26

    Article  PubMed  Google Scholar 

  22. AD Sperber Y Atzmon L Neumann I Weisberg Y Shalit M Abu-Shakrah et al. (1999) ArticleTitleFibromyalgia in the irritable bowel syndrome: studies of prevalence and clinical implications Am J Gastroenterol 94 IssueID12 3541–6 Occurrence Handle10606316 Occurrence Handle10.1111/j.1572-0241.1999.01643.x Occurrence Handle1:STN:280:DC%2BD3c%2Fnt1egsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  23. WE Whitehead O Palsson KR Jones (2002) ArticleTitleSystematic review of the comorbidity of irritable bowel syndrome with other disorders: what are the causes and implications? Gastroenterology 122 IssueID4 1140–56 Occurrence Handle11910364 Occurrence Handle10.1053/gast.2002.32392

    Article  PubMed  Google Scholar 

  24. DA Drossman (2006) ArticleTitleThe functional gastrointestinal disorders and the Rome III process Gastroenterology 130 IssueID5 1377–90 Occurrence Handle16678553 Occurrence Handle10.1053/j.gastro.2006.03.008

    Article  PubMed  Google Scholar 

  25. E Lubrano P Iovino F Tremolaterra WJ Parsons C Ciacci G Mazzacca (2001) ArticleTitleFibromyalgia in patients with irritable bowel syndrome: an association with the severity of the intestinal disorder Int J Colorectal Dis 16 IssueID4 211–5 Occurrence Handle11515679 Occurrence Handle10.1007/s003840100299 Occurrence Handle1:STN:280:DC%2BD3MvntVOhtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  26. GN Verne ME Robinson DD Price (2001) ArticleTitleHypersensitivity to visceral and cutaneous pain in the irritable bowel syndrome Pain 93 IssueID1 7–14 Occurrence Handle11406333 Occurrence Handle10.1016/S0304-3959(01)00285-8 Occurrence Handle1:STN:280:DC%2BD3MzktlCksg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  27. GN Verne DD Price (2002) ArticleTitleIrritable bowel syndrome as a common precipitant of central sensitization Curr Rheumatol Rep 4 IssueID4 322–8 Occurrence Handle12126584 Occurrence Handle10.1007/s11926-002-0041-x

    Article  PubMed  Google Scholar 

  28. GN Verne NC Himes ME Robinson KS Gopinath RW Briggs B Crosson et al. (2003) ArticleTitleCentral representation of visceral and cutaneous hypersensitivity in the irritable bowel syndrome Pain 103 IssueID1, 2 99–110 Occurrence Handle12749964 Occurrence Handle10.1016/S0304-3959(02)00416-5

    Article  PubMed  Google Scholar 

  29. DD Price Q Zhou B Moshiree ME Robinson G Nicholas Verne (2006) ArticleTitlePeripheral and central contributions to hyperalgesia in irritable bowel syndrome J Pain 7 IssueID8 529–35 Occurrence Handle16885007 Occurrence Handle10.1016/j.jpain.2005.12.011

    Article  PubMed  Google Scholar 

  30. L Chang S Berman EA Mayer B Suyenobu S Derbyshire B Naliboff et al. (2003) ArticleTitleBrain responses to visceral and somatic stimuli in patients with irritable bowel syndrome with and without fibromyalgia Am J Gastroenterol 98 IssueID6 1354–61 Occurrence Handle12818281 Occurrence Handle10.1111/j.1572-0241.2003.07478.x

    Article  PubMed  Google Scholar 

  31. IJ Cook A van Eeden SM Collins (1987) ArticleTitlePatients with irritable bowel syndrome have greater pain tolerance than normal subjects Gastroenterology 93 IssueID4 727–33 Occurrence Handle3623019 Occurrence Handle1:STN:280:DyaL2szgsFeksQ%3D%3D

    PubMed  CAS  Google Scholar 

  32. P Iovino F Tremolaterra D Consalvo F Sabbatini G Mazzacca C Ciacci (2006) ArticleTitlePerception of electrocutaneous stimuli in irritable bowel syndrome Am J Gastroenterol 101 IssueID3 596–603 Occurrence Handle16464229 Occurrence Handle10.1111/j.1572-0241.2006.00414.x

    Article  PubMed  Google Scholar 

  33. WE Whitehead B Holtkotter P Enck R Hoelzl KD Holmes J Anthony et al. (1990) ArticleTitleTolerance for rectosigmoid distention in irritable bowel syndrome Gastroenterology 98 IssueID5 Pt 1 1187–92 Occurrence Handle2323511 Occurrence Handle1:STN:280:DyaK3c3hsFSqtA%3D%3D

    PubMed  CAS  Google Scholar 

  34. TJ Ness T Powell-Boone R Cannon LK Lloyd RB Fillingim (2005) ArticleTitlePsychophysical evidence of hypersensitivity in subjects with interstitial cystitis J Urol 173 IssueID6 1983–7 Occurrence Handle15879797 Occurrence Handle10.1097/01.ju.0000158452.15915.e2

    Article  PubMed  Google Scholar 

  35. R Staud (2006) ArticleTitleBiology and therapy of fibromyalgia: pain in fibromyalgia syndrome Arthritis Res Ther 8 IssueID3 208 Occurrence Handle16684376 Occurrence Handle10.1186/ar1950

    Article  PubMed  Google Scholar 

  36. R Staud ME Rodriguez (2006) ArticleTitleMechanisms of disease: pain in fibromyalgia syndrome Nat Clin Pract Rheumatol 2 IssueID2 90–8 Occurrence Handle16932662 Occurrence Handle10.1038/ncprheum0091

    Article  PubMed  Google Scholar 

  37. IR Bell CM Baldwin GE Schwartz (2001) ArticleTitleSensitization studies in chemically intolerant individuals: implications for individual difference research Ann N Y Acad Sci 933 38–47 Occurrence Handle12000034 Occurrence Handle1:CAS:528:DC%2BD3MXjvVWqsbs%3D Occurrence Handle10.1111/j.1749-6632.2001.tb05812.x

    Article  PubMed  CAS  Google Scholar 

  38. J Nijs M Meeus K De Meirleir (2006) ArticleTitleChronic musculoskeletal pain in chronic fatigue syndrome: recent developments and therapeutic implications Man Ther 11 IssueID3 187–91 Occurrence Handle16781183 Occurrence Handle10.1016/j.math.2006.03.008

    Article  PubMed  Google Scholar 

  39. S Stander M Schmelz (2006) ArticleTitleChronic itch and pain: similarities and differences Eur J Pain 10 IssueID5 473–8 Occurrence Handle16678456 Occurrence Handle10.1016/j.ejpain.2006.03.005

    Article  PubMed  Google Scholar 

  40. HG Schaible A Ebersberger GS Von Banchet (2002) ArticleTitleMechanisms of pain in arthritis Ann N Y Acad Sci 966 343–54 Occurrence Handle12114291 Occurrence Handle1:CAS:528:DC%2BD38XlvVWmurc%3D Occurrence Handle10.1111/j.1749-6632.2002.tb04234.x

    Article  PubMed  CAS  Google Scholar 

  41. AB Petrenko T Yamakura H Baba K Shimoji (2003) ArticleTitleThe role of N-methyl-D-aspartate (NMDA) receptors in pain: a review Anesth Analg 97 IssueID4 1108–16 Occurrence Handle14500166 Occurrence Handle10.1213/01.ANE.0000081061.12235.55 Occurrence Handle1:CAS:528:DC%2BD3sXosVOkur4%3D

    Article  PubMed  CAS  Google Scholar 

  42. KG Henriksson J Sorensen (2002) ArticleTitleThe promise of N-methyl-D-aspartate receptor antagonists in fibromyalgia Rheum Dis Clin North Am 28 IssueID2 343–51 Occurrence Handle12122922 Occurrence Handle10.1016/S0889-857X(01)00013-8

    Article  PubMed  Google Scholar 

  43. PB Wood (2006) ArticleTitleA reconsideration of the relevance of systemic low-dose ketamine to the pathophysiology of fibromyalgia J Pain 7 IssueID9 611–4 Occurrence Handle16942946 Occurrence Handle10.1016/j.jpain.2006.01.457 Occurrence Handle1:CAS:528:DC%2BD28XptFCgtrs%3D

    Article  PubMed  CAS  Google Scholar 

  44. PL Delgado (2004) ArticleTitleCommon pathways of depression and pain J Clin Psychiatry 65 Suppl 12 16–9 Occurrence Handle15315473

    PubMed  Google Scholar 

  45. LM Arnold JI Hudson PE Keck MB Auchenbach KN Javaras EV Hess (2006) ArticleTitleComorbidity of fibromyalgia and psychiatric disorders J Clin Psychiatry 67 IssueID8 1219–25 Occurrence Handle16965199

    PubMed  Google Scholar 

  46. K Kato PF Sullivan B Evengard NL Pedersen (2006) ArticleTitleChronic widespread pain and its comorbidities: a population-based study Arch Intern Med 166 IssueID15 1649–54 Occurrence Handle16908799 Occurrence Handle10.1001/archinte.166.15.1649

    Article  PubMed  Google Scholar 

  47. SM Stahl (2002) ArticleTitleDoes depression hurt? J Clin Psychiatry 63 IssueID4 273–4 Occurrence Handle12000200

    PubMed  Google Scholar 

  48. RM Gendreau MD Thorn JF Gendreau JD Kranzler S Ribeiro RH Gracely et al. (2005) ArticleTitleEfficacy of milnacipran in patients with fibromyalgia J Rheumatol 32 IssueID10 1975–85 Occurrence Handle16206355 Occurrence Handle1:CAS:528:DC%2BD2MXhtFOqt7bJ

    PubMed  CAS  Google Scholar 

  49. L Gormsen AR Ribe P Raun R Rosenberg P Videbech P Vestergaard et al. (2004) ArticleTitlePain thresholds during and after treatment of severe depression with electroconvulsive therapy Eur J Pain 8 IssueID5 487–93 Occurrence Handle15324780 Occurrence Handle10.1016/j.ejpain.2003.11.015

    Article  PubMed  Google Scholar 

  50. C Usui N Doi M Nishioka H Komatsu R Yamamoto T Ohkubo et al. (2006) ArticleTitleElectroconvulsive therapy improves severe pain associated with fibromyalgia Pain 121 IssueID3 276–80 Occurrence Handle16495009 Occurrence Handle10.1016/j.pain.2005.12.025

    Article  PubMed  Google Scholar 

  51. T Giesecke RH Gracely DA Williams ME Geisser FW Petzke DJ Clauw (2005) ArticleTitleThe relationship between depression, clinical pain, and experimental pain in a chronic pain cohort Arthritis Rheum 52 IssueID5 1577–84 Occurrence Handle15880832 Occurrence Handle10.1002/art.21008

    Article  PubMed  Google Scholar 

  52. W Boucher M el-Mansoury X Pang GR Sant TC Theoharides (1995) ArticleTitleElevated mast cell tryptase in the urine of patients with interstitial cystitis Br J Urol 76 IssueID1 94–100 Occurrence Handle7648070 Occurrence Handle1:STN:280:DyaK2Mzns1WjsA%3D%3D Occurrence Handle10.1111/j.1464-410X.1995.tb07840.x

    Article  PubMed  CAS  Google Scholar 

  53. X Pang W Boucher G Triadafilopoulos GR Sant TC Theoharides (1996) ArticleTitleMast cell and substance P-positive nerve involvement in a patient with both irritable bowel syndrome and interstitial cystitis Urology 47 IssueID3 436–8 Occurrence Handle8633418 Occurrence Handle10.1016/S0090-4295(99)80469-5 Occurrence Handle1:STN:280:DyaK283hslykug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  54. G Barbara V Stanghellini R De Giorgio C Cremon GS Cottrell D Santini et al. (2004) ArticleTitleActivated mast cells in proximity to colonic nerves correlate with abdominal pain in irritable bowel syndrome Gastroenterology 126 IssueID3 693–702 Occurrence Handle14988823 Occurrence Handle10.1053/j.gastro.2003.11.055

    Article  PubMed  Google Scholar 

  55. M Guilarte J Santos I de Torres C Alonso M Vicario L Ramos et al. (2006) ArticleTitleDiarrhoea-predominant IBS patients show mast cell activation and hyperplasia in the jejunum Gut 56 203–209 Occurrence Handle17005763 Occurrence Handle10.1136/gut.2006.100594

    Article  PubMed  Google Scholar 

  56. J Wood (2006) ArticleTitleHistamine, mast cells, and the enteric nervous system in the irritable bowel syndrome, enteritis, and food allergies Gut 55 445–447 Occurrence Handle16531524 Occurrence Handle10.1136/gut.2005.079046 Occurrence Handle1:STN:280:DC%2BD287kt1GjsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  57. JH La TW Kim TS Sung HJ Kim JY Kim IS Yang (2004) ArticleTitleRole of mucosal mast cells in visceral hypersensitivity in a rat model of irritable bowel syndrome J Vet Sci 5 IssueID4 319–24 Occurrence Handle15613815

    PubMed  Google Scholar 

  58. Y Zuo NM Perkins DJ Tracey CL Geczy (2003) ArticleTitleInflammation and hyperalgesia induced by nerve injury in the rat: a key role of mast cells Pain 105 IssueID3 467–79 Occurrence Handle14527707 Occurrence Handle10.1016/S0304-3959(03)00261-6

    Article  PubMed  Google Scholar 

  59. SK Bohm W Kong D Bromme SP Smeekens DC Anderson A Connolly et al. (1996) ArticleTitleMolecular cloning, expression and potential functions of the human proteinase-activated receptor-2 Biochem J 314 IssueIDPt 3 1009–16 Occurrence Handle8615752

    PubMed  Google Scholar 

  60. SR Macfarlane MJ Seatter T Kanke GD Hunter R Plevin (2001) ArticleTitleProteinase-activated receptors Pharmacol Rev 53 IssueID2 245–82 Occurrence Handle11356985 Occurrence Handle1:CAS:528:DC%2BD3MXkt1GnurY%3D

    PubMed  CAS  Google Scholar 

  61. A Kawabata N Kawao R Kuroda A Tanaka H Itoh H Nishikawa (2001) ArticleTitlePeripheral PAR-2 triggers thermal hyperalgesia and nociceptive responses in rats Neuroreport 12 IssueID4 715–9 Occurrence Handle11277570 Occurrence Handle10.1097/00001756-200103260-00020 Occurrence Handle1:CAS:528:DC%2BD3MXisVygsLc%3D

    Article  PubMed  CAS  Google Scholar 

  62. N Vergnolle NW Bunnett KA Sharkey V Brussee SJ Compton EF Grady et al. (2001) ArticleTitleProteinase-activated receptor-2 and hyperalgesia: a novel pain pathway Nat Med 7 IssueID7 821–6 Occurrence Handle11433347 Occurrence Handle10.1038/89945 Occurrence Handle1:CAS:528:DC%2BD3MXltVSmsr8%3D

    Article  PubMed  CAS  Google Scholar 

  63. AM Coelho N Vergnolle B Guiard J Fioramonti L Bueno (2002) ArticleTitleProteinases and proteinase-activated receptor 2: a possible role to promote visceral hyperalgesia in rats Gastroenterology 122 IssueID4 1035–47 Occurrence Handle11910355 Occurrence Handle10.1053/gast.2002.32387 Occurrence Handle1:CAS:528:DC%2BD38XjtFOmu78%3D

    Article  PubMed  CAS  Google Scholar 

  64. L Bueno (2005) ArticleTitleGastrointestinal pharmacology: irritable bowel syndrome Curr Opin Pharmacol 5 IssueID6 583–8 Occurrence Handle16188501 Occurrence Handle10.1016/j.coph.2005.06.006 Occurrence Handle1:CAS:528:DC%2BD2MXhtFKntrvF

    Article  PubMed  CAS  Google Scholar 

  65. G Barbara V Stanghellini R De Giorgio R Corinaldesi (2006) ArticleTitleFunctional gastrointestinal disorders and mast cells: implications for therapy Neurogastroenterol Motil 18 IssueID1 6–17 Occurrence Handle16371078 Occurrence Handle10.1111/j.1365-2982.2005.00685.x Occurrence Handle1:STN:280:DC%2BD2MnotlOgtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  66. N Kawao H Ikeda T Kitano R Kuroda F Sekiguchi K Kataoka et al. (2004) ArticleTitleModulation of capsaicin-evoked visceral pain and referred hyperalgesia by protease-activated receptors 1 and 2 J Pharmacol Sci 94 IssueID3 277–85 Occurrence Handle15037813 Occurrence Handle10.1254/jphs.94.277 Occurrence Handle1:CAS:528:DC%2BD2cXislCnurc%3D

    Article  PubMed  CAS  Google Scholar 

  67. Cenac N, Andrews CN, Holzhausen M, Chapman K, Cottrell G, Andrade-Gordon P, et al. Role for protease activity in visceral pain in irritable bowel syndrome. J Clin Invest 2007. Feb 15 [Epub ahead of print]

  68. D Ding-Pfennigdorff B Averbeck M Michaelis (2004) ArticleTitleStimulation of PAR-2 excites and sensitizes rat cutaneous C-nociceptors to heat Neuroreport 15 IssueID13 2071–5 Occurrence Handle15486484 Occurrence Handle10.1097/00001756-200409150-00015 Occurrence Handle1:CAS:528:DC%2BD2cXntFSgs7s%3D

    Article  PubMed  CAS  Google Scholar 

  69. C Moormann M Artuc E Pohl G Varga J Buddenkotte N Vergnolle et al. (2006) ArticleTitleFunctional characterization and expression analysis of the proteinase-activated receptor-2 in human cutaneous mast cells J Invest Dermatol 126 IssueID4 746–55 Occurrence Handle16470180 Occurrence Handle10.1038/sj.jid.5700169 Occurrence Handle1:CAS:528:DC%2BD28XitlKnsLg%3D

    Article  PubMed  CAS  Google Scholar 

  70. S Enestrom A Bengtsson T Frodin (1997) ArticleTitleDermal IgG deposits and increase of mast cells in patients with fibromyalgia-relevant findings or epiphenomena? Scand J Rheumatol 26 IssueID4 308–13 Occurrence Handle9310112 Occurrence Handle1:STN:280:DyaK2svlsF2jsg%3D%3D Occurrence Handle10.3109/03009749709105321

    Article  PubMed  CAS  Google Scholar 

  71. S Salemi J Rethage U Wollina BA Michel RE Gay S Gay et al. (2003) ArticleTitleDetection of interleukin 1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha in skin of patients with fibromyalgia J Rheumatol 30 IssueID1 146–50 Occurrence Handle12508404 Occurrence Handle1:CAS:528:DC%2BD3sXps1GqtA%3D%3D

    PubMed  CAS  Google Scholar 

  72. J Santos E Saperas C Nogueiras M Mourelle M Antolin A Cadahia et al. (1998) ArticleTitleRelease of mast cell mediators into the jejunum by cold pain stress in humans Gastroenterology 114 IssueID4 640–8 Occurrence Handle9516384 Occurrence Handle10.1016/S0016-5085(98)70577-3 Occurrence Handle1:STN:280:DyaK1c7osVOqsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  73. TC Theoharides D Papaliodis M Tagen A Konstantinidou D Kempuraj A Clemons (2005) ArticleTitleChronic fatigue syndrome, mast cells, and tricyclic antidepressants J Clin Psychopharmacol 25 IssueID6 515–20 Occurrence Handle16282830 Occurrence Handle10.1097/01.jcp.0000193483.89260.a7

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kayo Masuko.

About this article

Cite this article

Masuko, K., Nakamura, H. Functional somatic syndrome: how it could be relevant to rheumatologists. Mod Rheumatol 17, 179–184 (2007). https://doi.org/10.1007/s10165-007-0563-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10165-007-0563-1

Key words

Navigation