Login Register Cart 0
Generic placeholder image

Current Rheumatology Reviews

Editor-in-Chief

ISSN (Print): 1573-3971
ISSN (Online): 1875-6360

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Subcategories of Fibromyalgia - A New Concept

Author(s): Samy Metyas*, Christina Chen, Marina Joseph, Nicholas Hanna, Joseph Basta and Andrew Khalil

Volume 19, Issue 1, 2023

Published on: 14 April, 2022

Page: [18 - 25] Pages: 8

DOI: 10.2174/2666255815666220225103234

Price: $65

Abstract

Fibromyalgia has previously been categorized as primary, secondary, and juvenile fibromyalgia. However, these definitions do not adequately explain the etiopathology of disease, nor do they help direct new specific therapies. Herein, we review the previously known categorizations of fibromyalgia. Based on common patient characteristics and previously studied pathophysiologies, we propose new subcategorizations of fibromyalgia that we have self-narrated, including hormonal fibromyalgia, neuroendocrine fibromyalgia, psychologic fibromyalgia, inflammatory fibromyalgia, and lastly neuropathic fibromyalgia. To verify, add to, and fully describe these selfnarrated categories of fibromyalgia that we have proposed, future research needs to be done.

Keywords: Fibromyalgia, subcategory, primary, secondary, hormonal, inflammatory, juvenile, neuroendocrine.

« Previous Next »
Graphical Abstract

[1]
Häuser W, Ablin J, Fitzcharles MA, et al. Fibromyalgia. Nat Rev Dis Primers 2015; 1(1): 15022.
[http://dx.doi.org/10.1038/nrdp.2015.22] [PMID: 27189527]
[2]
Cabo-Meseguer A, Cerdá-Olmedo G, Trillo-Mata JL. Fibromyalgia: Prevalence, epidemiologic profiles and economic costs. Med Clin (Barc) 2017; 149(10): 441-8.
[http://dx.doi.org/10.1016/j.medcli.2017.06.008] [PMID: 28734619]
[3]
Duque L, Fricchione G. Fibromyalgia and its new lessons for neuropsychiatry. Med Sci Monit Basic Res 2019; 25: 169-78.
[http://dx.doi.org/10.12659/MSMBR.915962] [PMID: 31273184]
[4]
Wolfe F, Walitt B, Perrot S, Rasker JJ, Häuser W. Fibromyalgia diagnosis and biased assessment: Sex, prevalence and bias. PLoS One 2018; 13(9): e0203755.
[http://dx.doi.org/10.1371/journal.pone.0203755] [PMID: 30212526]
[5]
Talotta R, Bazzichi L, Di Franco M, et al. One year in review 2017: Fibromyalgia. Clin Exp Rheumatol 2017; (35 Suppl)105(3): 6-12.
[6]
Bellato E, Marini E, Castoldi F, et al. Fibromyalgia syndrome: Etiology, pathogenesis, diagnosis, and treatment. Pain Res Treat 2012; 2012: 426130.
[http://dx.doi.org/10.1155/2012/426130] [PMID: 23213512]
[7]
Schweinhardt P, Fitzcharles MA, Boomershine C, Vierck C, Yunus MB. Fibromyalgia as a disorder related to distress and its therapeutic implications. Pain Res Treat 2012; 2012: 950602.
[http://dx.doi.org/10.1155/2012/950602] [PMID: 22482049]
[8]
Theoharides TC, Tsilioni I, Arbetman L, et al. Fibromyalgia syndrome in need of effective treatments. J Pharmacol Exp Ther 2015; 355(2): 255-63.
[http://dx.doi.org/10.1124/jpet.115.227298] [PMID: 26306765]
[9]
Woodman I. Fibromyalgia: fibromyalgia-all in the brain? Nat Rev Rheumatol 2013; 9(10): 565.
[http://dx.doi.org/10.1038/nrrheum.2013.137] [PMID: 24045710]
[10]
Masi AT, Vincent A. A historical and clinical perspective endorsing person-centered management of fibromyalgia syndrome. Curr Rheumatol Rev 2015; 11(2): 86-95.
[http://dx.doi.org/10.2174/1573397111666150619094420] [PMID: 26088217]
[11]
Yunus MB, Masi AT. Juvenile primary fibromyalgia syndrome. A clinical study of thirty-three patients and matched normal controls. Arthritis Rheum 1985; 28(2): 138-45.
[http://dx.doi.org/10.1002/art.1780280205] [PMID: 3871615]
[12]
Häuser W, Fitzcharles MA. Facts and myths pertaining to fibromyalgia. Dialogues Clin Neurosci 2018; 20(1): 53-62.
[http://dx.doi.org/10.31887/DCNS.2018.20.1/whauser] [PMID: 29946212]
[13]
Calandre EP, Garcia-Carrillo J, Garcia-Leiva JM, Rico-Villademoros F, Molina-Barea R, Rodriguez-Lopez CM. Subgrouping patients with fibromyalgia according to the results of the Fibromyalgia Impact Questionnaire: A replication study. Rheumatol Int 2011; 31(12): 1555-9.
[http://dx.doi.org/10.1007/s00296-010-1521-3] [PMID: 20490804]
[14]
Kia S, Choy E. Update on treatment guideline in fibromyalgia syndrome with focus on pharmacology. Biomedicines 2017; 5(2): 20.
[http://dx.doi.org/10.3390/biomedicines5020020] [PMID: 28536363]
[15]
Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis 2017; 76(2): 318-28.
[http://dx.doi.org/10.1136/annrheumdis-2016-209724] [PMID: 27377815]
[16]
Kashikar-Zuck S, Ting TV. Juvenile fibromyalgia: Current status of research and future developments. Nat Rev Rheumatol 2014; 10(2): 89-96.
[http://dx.doi.org/10.1038/nrrheum.2013.177] [PMID: 24275966]
[17]
Wolfe F, Smythe HA, Yunus MB, 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.
[http://dx.doi.org/10.1002/art.1780330203] [PMID: 2306288]
[18]
Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American college of rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken) 2010; 62(5): 600-10.
[http://dx.doi.org/10.1002/acr.20140] [PMID: 20461783]
[19]
Ceko M, Bushnell MC, Gracely RH. Neurobiology underlying fibromyalgia symptoms. Pain Res Treat 2012; 2012: 585419.
[http://dx.doi.org/10.1155/2012/585419] [PMID: 22135739]
[20]
Furness PJ, Vogt K, Ashe S, Taylor S, Haywood-Small S, Lawson K. What causes fibromyalgia? An online survey of patient perspectives. Health Psychol Open 2018; 5(2): 2055102918802683.
[http://dx.doi.org/10.1177/2055102918802683] [PMID: 30275965]
[21]
Häuser W, Petzke F, Sommer C. Comparative efficacy and harms of duloxetine, milnacipran, and pregabalin in fibromyalgia syndrome. J Pain 2010; 11(6): 505-21.
[http://dx.doi.org/10.1016/j.jpain.2010.01.002] [PMID: 20418173]
[22]
Arnold LM, Clauw DJ, Dunegan LJ, Turk DC. FibroCollaborative. A framework for fibromyalgia management for primary care providers. Mayo Clin Proc 2012; 87(5): 488-96.
[http://dx.doi.org/10.1016/j.mayocp.2012.02.010] [PMID: 22560527]
[23]
Wolfe F, Walitt B, Rasker JJ, Häuser W. Primary and secondary fibromyalgia are the same: The universality of polysymptomatic distress. J Rheumatol 2019; 46(2): 204-12.
[http://dx.doi.org/10.3899/jrheum.180083] [PMID: 30008459]
[24]
Bennett RM, Friend R. Secondary fibromyalgia. J Rheumatol 2019; 46(2): 127-9.
[http://dx.doi.org/10.3899/jrheum.180611] [PMID: 30710001]
[25]
Gist AC, Guymer EK, Eades LE, Leech M, Littlejohn GO. Fibromyalgia remains a significant burden in rheumatoid arthritis patients in Australia. Int J Rheum Dis 2018; 21(3): 639-46.
[http://dx.doi.org/10.1111/1756-185X.13055] [PMID: 28296177]
[26]
Lee YC, Lu B, Boire G, et al. Incidence and predictors of secondary fibromyalgia in an early arthritis cohort. Ann Rheum Dis 2013; 72(6): 949-54.
[http://dx.doi.org/10.1136/annrheumdis-2012-201506] [PMID: 22791744]
[27]
Aloush V, Ablin JN, Reitblat T, Caspi D, Elkayam O. Fibromyalgia in women with ankylosing spondylitis. Rheumatol Int 2007; 27(9): 865-8.
[http://dx.doi.org/10.1007/s00296-007-0344-3] [PMID: 17476510]
[28]
De Sanctis V, Abbasciano V, Soliman AT, et al. The juvenile fibromyalgia syndrome (JFMS): A poorly defined disorder. Acta Biomed 2019; 90(1): 134-48.
[PMID: 30889168]
[29]
Gmuca S, Sherry DD. Fibromyalgia: Treating pain in the juvenile patient. Paediatr Drugs 2017; 19(4): 325-38.
[http://dx.doi.org/10.1007/s40272-017-0233-5] [PMID: 28536810]
[30]
Kashikar-Zuck S, Parkins IS, Graham TB, et al. Anxiety, mood, and behavioral disorders among pediatric patients with juvenile fibromyalgia syndrome. Clin J Pain 2008; 24(7): 620-6.
[http://dx.doi.org/10.1097/AJP.0b013e31816d7d23] [PMID: 18716501]
[31]
McLeod JD. Juvenile fibromyalgia syndrome and improved recognition by pediatric primary care providers. J Pediatr Health Care 2014; 28(2): e9-e18.
[http://dx.doi.org/10.1016/j.pedhc.2013.05.008] [PMID: 23988610]
[32]
White HD, Brown LAJ, Gyurik RJ, et al. Treatment of pain in fibromyalgia patients with testosterone gel: Pharmacokinetics and clinical response. Int Immunopharmacol 2015; 27(2): 249-56.
[http://dx.doi.org/10.1016/j.intimp.2015.05.016] [PMID: 26004317]
[33]
Schertzinger M, Wesson-Sides K, Parkitny L, Younger J. Daily fluctuations of progesterone and testosterone are associated with fibromyalgia pain severity. J Pain 2018; 19(4): 410-7.
[http://dx.doi.org/10.1016/j.jpain.2017.11.013] [PMID: 29248511]
[34]
Jones KD, Deodhar P, Lorentzen A, Bennett RM, Deodhar AA. Growth hormone perturbations in fibromyalgia: A review. Semin Arthritis Rheum 2007; 36(6): 357-79.
[http://dx.doi.org/10.1016/j.semarthrit.2006.09.006] [PMID: 17224178]
[35]
Bennett RM, Clark SC, Walczyk J. A randomized, double-blind, placebo-controlled study of growth hormone in the treatment of fibromyalgia. Am J Med 1998; 104(3): 227-31.
[http://dx.doi.org/10.1016/S0002-9343(97)00351-3] [PMID: 9552084]
[36]
Cuatrecasas G, Riudavets C, Güell MA, Nadal A. Growth hormone as concomitant treatment in severe fibromyalgia associated with low IGF-1 serum levels. A pilot study. BMC Musculoskeletal Disorders 2007; 8: 119.
[37]
Cutsforth-Gregory JK, Sandroni P. Clinical neurophysiology of postural tachycardia syndrome. Handb Clin Neurol 2019; 161: 429-45.
[http://dx.doi.org/10.1016/B978-0-444-64142-7.00066-7] [PMID: 31307619]
[38]
Staud R. Autonomic dysfunction in fibromyalgia syndrome: Postural orthostatic tachycardia. Curr Rheumatol Rep 2008; 10(6): 463-6.
[http://dx.doi.org/10.1007/s11926-008-0076-8] [PMID: 19007537]
[39]
Sheldon RS, Grubb BP II, Olshansky B, et al. 2015 Heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm 2015; 12(6): e41-63.
[http://dx.doi.org/10.1016/j.hrthm.2015.03.029] [PMID: 25980576]
[40]
Zadourian A, Doherty TA, Swiatkiewicz I, Taub PR. Postural orthostatic tachycardia syndrome: Prevalence, pathophysiology, and management. Drugs 2018; 78(10): 983-94.
[http://dx.doi.org/10.1007/s40265-018-0931-5] [PMID: 29943373]
[41]
Jacob G, Costa F, Shannon JR, et al. The neuropathic postural tachycardia syndrome. N Engl J Med 2000; 343(14): 1008-14.
[http://dx.doi.org/10.1056/NEJM200010053431404] [PMID: 11018167]
[42]
Yang TY, Chen CS, Lin CL, Lin WM, Kuo CN, Kao CH. Risk for irritable bowel syndrome in fibromyalgia patients: A national database study. Medicine (Baltimore) 2017; 96(14): e6657.
[http://dx.doi.org/10.1097/MD.0000000000006657] [PMID: 28383443]
[43]
Nozu T, Kudaira M, Kitamori S, Uehara A. Repetitive rectal painful distention induces rectal hypersensitivity in patients with irritable bowel syndrome. J Gastroenterol 2006; 41(3): 217-22.
[http://dx.doi.org/10.1007/s00535-005-1748-z] [PMID: 16699855]
[44]
Gupta V, Sheffield D, Verne GN. Evidence for autonomic dysregulation in the irritable bowel syndrome. Dig Dis Sci 2002; 47(8): 1716-22.
[http://dx.doi.org/10.1023/A:1016424007454] [PMID: 12184520]
[45]
Chalaye P, Goffaux P, Bourgault P, et al. Comparing pain modulation and autonomic responses in fibromyalgia and irritable bowel syndrome patients. Clin J Pain 2012; 28(6): 519-26.
[http://dx.doi.org/10.1097/AJP.0b013e31823ae69e] [PMID: 22673485]
[46]
Martínez-Martínez LA, Mora T, Vargas A, Fuentes-Iniestra M, Martínez-Lavín M. Sympathetic nervous system dysfunction in fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, and interstitial cystitis: A review of case-control studies. J Clin Rheumatol 2014; 20(3): 146-50.
[http://dx.doi.org/10.1097/RHU.0000000000000089] [PMID: 24662556]
[47]
Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome: A clinical review. JAMA 2015; 313(9): 949-58.
[http://dx.doi.org/10.1001/jama.2015.0954]
[48]
Ford AC, Moayyedi P, Chey WD, et al. ACG task force on management of irritable bowel syndrome. American college of gastroenterology monograph on management of irritable bowel syndrome. Am J Gastroenterol 2018; 113 (Suppl. 2): 1-18.
[http://dx.doi.org/10.1038/s41395-018-0084-x] [PMID: 29950604]
[49]
Fietta P, Fietta P, Manganelli P. Fibromyalgia and psychiatric disorders. Acta Biomed 2007; 78(2): 88-95.
[PMID: 17933276]
[50]
Løge-Hagen JS, Sæle A, Juhl C, Bech P, Stenager E, Mellentin AI. Prevalence of depressive disorder among patients with fibromyalgia: Systematic review and meta-analysis. J Affect Disord 2019; 245(245): 1098-105.
[http://dx.doi.org/10.1016/j.jad.2018.12.001] [PMID: 30699852]
[51]
Gracely RH, Ceko M, Bushnell MC. Fibromyalgia and depression. Pain Res Treat 2012; 2012: 486590.
[http://dx.doi.org/10.1155/2012/486590] [PMID: 22191023]
[52]
Arnold LM, Hudson JI, Keck PE Jr, Auchenbach MB, Javaras KN, Hess EV. Comorbidity of fibromyalgia and psychiatric disorders. J Clin Psychiatry 2006; 67(8): 1219-25.
[http://dx.doi.org/10.4088/JCP.v67n0807] [PMID: 16965199]
[53]
Carta MG, Moro MF, Pinna FL, et al. The impact of fibromyalgia syndrome and the role of comorbidity with mood and post-traumatic stress disorder in worsening the quality of life. Int J Soc Psychiatry 2018; 64(7): 647-55.
[http://dx.doi.org/10.1177/0020764018795211] [PMID: 30146928]
[54]
Kato K, Sullivan PF, Evengård B, Pedersen NL. Importance of genetic influences on chronic widespread pain. Arthritis Rheum 2006; 54(5): 1682-6.
[http://dx.doi.org/10.1002/art.21798] [PMID: 16646040]
[55]
Ablin JN, Cohen H, Buskila D. Mechanisms of disease: Genetics of fibromyalgia. Nat Clin Pract Rheumatol 2006; 2(12): 671-8.
[http://dx.doi.org/10.1038/ncprheum0349] [PMID: 17133252]
[56]
Bradley LA. Pathophysiology of fibromyalgia. Am J Med 2009; 122(12 Suppl.): S22-30.
[http://dx.doi.org/10.1016/j.amjmed.2009.09.008] [PMID: 19962493]
[57]
Alok R, Das SK, Agarwal GG, Salwahan L, Srivastava R. Relationship of severity of depression, anxiety and stress with severity of fibromyalgia. Clin Exp Rheumatol 2011; 29(6) (Suppl. 69): S70-2.
[PMID: 22243551]
[58]
Senna MK, Ahmad HS, Fathi W. Depression in obese patients with primary fibromyalgia: The mediating role of poor sleep and eating disorder features. Clin Rheumatol 2013; 32(3): 369-75.
[http://dx.doi.org/10.1007/s10067-012-2132-z] [PMID: 23208722]
[59]
Metyas S, Rezk T, Arkfeld D, Leptich T. Autoinflammation and immunomodulation in inflammatory fibromyalgia syndrome - A review. Curr Rheumatol Rev 2017; 13(2): 98-102.
[http://dx.doi.org/10.2174/1573397112666160919120530] [PMID: 27655626]
[60]
Metyas SK, Solyman JS, Arkfeld DG. Inflammatory fibromyalgia: Is it real? Curr Rheumatol Rev 2015; 11(1): 15-7.
[http://dx.doi.org/10.2174/1573397111666150522095004] [PMID: 26002453]
[61]
Cheema R, Chang-Miller A, Aslam F. Myalgia with elevated inflammatory markers in an obese young female: Fibromyalgia or polymyalgia rheumatica? Am J Case Rep 2019; 20: 659-63.
[http://dx.doi.org/10.12659/AJCR.915564] [PMID: 31064976]
[62]
Theoharides TC, Tsilioni I, Bawazeer M. Mast cells, neuroinflammation and pain in fibromyalgia syndrome. Front Cell Neurosci 2019; 13: 353.
[http://dx.doi.org/10.3389/fncel.2019.00353] [PMID: 31427928]
[63]
Theoharides TC, Donelan J, Kandere-Grzybowska K, Konstantinidou A. The role of mast cells in migraine pathophysiology. Brain Res Brain Res Rev 2005; 49(1): 65-76.
[http://dx.doi.org/10.1016/j.brainresrev.2004.11.006] [PMID: 15960987]
[64]
Mendieta D, De la Cruz-Aguilera DL, Barrera-Villalpando MI, et al. IL-8 and IL-6 primarily mediate the inflammatory response in fi-bromyalgia patients. J Neuroimmunol 2016; 290: 22-5.
[http://dx.doi.org/10.1016/j.jneuroim.2015.11.011] [PMID: 26711564]
[65]
Mian AN, Chaabo K, Wajed J, et al. Rheumatoid arthritis patients with fibromyalgic clinical features have significantly less synovitis as defined by power Doppler ultrasound. BMC Musculoskelet Disord 2016; 17(1): 404.
[http://dx.doi.org/10.1186/s12891-016-1258-6] [PMID: 27659057]
[66]
Bote ME, García JJ, Hinchado MD, Ortega E. Inflammatory/stress feedback dysregulation in women with fibromyalgia. Neuroimmunomodulation 2012; 19(6): 343-51.
[http://dx.doi.org/10.1159/000341664] [PMID: 22986514]
[67]
Okifuji A, Bradshaw DH, Olson C. Evaluating obesity in fibromyalgia: Neuroendocrine biomarkers, symptoms, and functions. Clin Rheumatol 2009; 28(4): 475-8.
[http://dx.doi.org/10.1007/s10067-009-1094-2] [PMID: 19172342]
[68]
Feinberg T, Sambamoorthi U, Lilly C, Innes KK. Potential mediators between fibromyalgia and C-reactive protein: Results from a Large US Community Survey. BMC Musculoskelet Disord 2017; 18(1): 294.
[http://dx.doi.org/10.1186/s12891-017-1641-y] [PMID: 28687081]
[69]
Salemi S, Rethage J, Wollina U, et al. Detection of interleukin 1beta (IL-1beta), IL-6, and tumor necrosis factor-alpha in skin of patients with fibromyalgia. J Rheumatol 2003; 30(1): 146-50.
[PMID: 12508404]
[70]
Schwarz MJ, Späth M, Müller-Bardorff H, Pongratz DE, Bondy B, Ackenheil M. Relationship of substance P, 5-hydroxyindole acetic acid and tryptophan in serum of fibromyalgia patients. Neurosci Lett 1999; 259(3): 196-8.
[http://dx.doi.org/10.1016/S0304-3940(98)00937-9] [PMID: 10025591]
[71]
Quismorio AV, Solyman J, Asfahani L, Metyas SK. Elevated serum leptin levels in a subset of fibromyalgia patients with high inflammatory markers. American College of Rheumatology Annual Meeting. 2014 Nov 14-19; Boston, United States of America..
[72]
Ataoglu S, Ankarali H, Samanci R, Ozsahin M, Admis O. The relationship between serum leptin level and disease activity and inflammatory markers in fibromyalgia patients. North Clin Istanb 2018; 5(2): 102-8.
[PMID: 30374474]
[73]
Fantuzzi G, Faggioni R. Leptin in the regulation of immunity, inflammation, and hematopoiesis. J Leukoc Biol 2000; 68(4): 437-46.
[PMID: 11037963]
[74]
Andrés-Rodríguez L, Borràs X, Feliu-Soler A, et al. Machine learning to understand the immune-inflammatory pathways in fibromyalgia. Int J Mol Sci 2019; 20(17): 4231.
[http://dx.doi.org/10.3390/ijms20174231] [PMID: 31470635]
[75]
Scholz J, Woolf CJ. The neuropathic pain triad: Neurons, immune cells and glia. Nat Neurosci 2007; 10(11): 1361-8.
[http://dx.doi.org/10.1038/nn1992] [PMID: 17965656]
[76]
Oaklander AL, Herzog ZD, Downs HM, Klein MM. Objective evidence that small-fiber polyneuropathy underlies some illnesses currently labeled as fibromyalgia. Pain 2013; 154(11): 2310-6.
[http://dx.doi.org/10.1016/j.pain.2013.06.001] [PMID: 23748113]
[77]
Levine TD, Saperstein DS. Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients. Clin Rheumatol 2015; 34(3): 413-7.
[http://dx.doi.org/10.1007/s10067-014-2850-5] [PMID: 25535201]
[78]
Metyas S, Chen C, Quismorio A, Abdo N, Kamel K. Improvement of nerve fiber density in fibromyalgia patients treated with IVIg. Curr Rheumatol Rev 2020; 16(4): 280-4.
[http://dx.doi.org/10.2174/1573397115666191106120622] [PMID: 31702528]
[79]
Hovaguimian A, Gibbons CH. Diagnosis and treatment of pain in small-fiber neuropathy. Curr Pain Headache Rep 2011; 15(3): 193-200.
[http://dx.doi.org/10.1007/s11916-011-0181-7] [PMID: 21286866]
[80]
Kiguchi N, Kobayashi Y, Kishioka S. Chemokines and cytokines in neuroinflammation leading to neuropathic pain. Curr Opin Pharmacol 2012; 12(1): 55-61.
[http://dx.doi.org/10.1016/j.coph.2011.10.007] [PMID: 22019566]
[81]
Littlejohn G. Neurogenic neuroinflammation in fibromyalgia and complex regional pain syndrome. Nat Rev Rheumatol 2015; 11(11): 639-48.
[http://dx.doi.org/10.1038/nrrheum.2015.100] [PMID: 26241184]
[82]
Häuser W, Sarzi-Puttini P, Fitzcharles MA. Fibromyalgia syndrome: Under-, over- and misdiagnosis. Clin Exp Rheumatol 2019; 37(1 Suppl. 116): 90-7.
[83]
García Rodríguez DF, Abud Mendoza C. Physiopathology of fibromyalgia. Reumatol Clin 2020; 16(3): 191-4.
[http://dx.doi.org/10.1016/j.reumae.2020.02.004] [PMID: 32279983]

Rights & Permissions Print Cite
Article Metrics
31
1
© 2024 Bentham Science Publishers | Privacy Policy