儿童原发纤维肌痛综合征的临床分析

目的探讨儿童型纤维肌痛综合征（FMS）的临床特点。方法对1997年3月-2004年11月间我院收治的6例FMS患儿的临床表现、实验室检查以及治疗效果进行回顾性分析,并复习国内外文献。结果6例FMS患儿中,5例女性患儿均以腹痛起病,1例男性患儿以广泛性疼痛及左膝关节痛起病,均误诊为其他疾病。6例FMS患儿均有全身弥漫性疼痛（平均疼痛得分8．8,压痛点数13．7个）、疲乏、睡眠障碍、气温下降及活动后疼痛加重,出现关节痛、肌痉挛、腹痛、肠激惹征及尿急各有5例患儿,痛经4例,抑郁3例,晨僵、感觉异常及焦虑各2例。实验室和器械检查基本正常,治疗效果尚可。结论儿童FMS临床并非少见,应引起重视,避免误诊。

Clinical analysis of six cases with juvenile primary fibromyalgia syndrome

Objective To study the clinical features of juvenile primary fibromyalgia syndrome(FMS) and to evaluate outcome after treatment.Methods Six patients with juvenile primary FMS were registered in department of rheumatology and their clinical data were assessed,including degree of pain(visual analog scale,VAS),fatigue,depression,anxiety,sleep disturbances,arthrodynia,subjective joint swelling,abdominal pain,irritable bowel symptoms,urinary urgency,dysmenorrhea,morning stiffness,paresthesias,illness changes with weather,feeling worse with exercise,laboratory examination and outcome of treatment.Results Abdominal pain was the first symptom in 5 of the cases with juvenile primary FMS,diffuse aching and left knee pain were the first symptoms in one patient.All the 6 patients were misdiagnosed prior to their rheumatological evaluation.Diffuse aching,fatigue,sleep disturbances,illness changes with weather and feeling worse with exercise existed in all the 6 patients(100%),the mean pain score was 8.8 and the mean initial tender points(TP) count was 13.7.Arthrodynia,subjective joint swelling,abdominal pain,irritable bowel symptoms and urinary urgency existed in 5 of the 6 patients(83%).Dysmenorrhea existed in 4(67%),depression in 3(50%),morning stiffness in 2(33%),paresthesias in 2(33%) and anxiety in 2(33%),respectively.The results of laboratory examination were normal and the outcomes of treatment were good.Conclusion Juvenile primary FMS may not be a rare disease and the clinicians should pay more attention to it for avoiding misdiagnosis.