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Vol. 1. Núm. 4.
Páginas 200-210 (Noviembre - Diciembre 2005)
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Vol. 1. Núm. 4.
Páginas 200-210 (Noviembre - Diciembre 2005)
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¿Existe asociación entre la fibromialgia, el aumento de la comorbilidad por enfermedad neoplásica, cardiovascular e infecciones, y el de la mortalidad?
Is there an association between fibromyalgia and an increase in comorbidity: neoplastic and cardiovascular diseases, infections and mortality?
Visitas
...
E. Chamizo-Carmona??
Autor para correspondencia
eugeniochamizo@arrakis.es

Correspondencia: Dr. E. Chamizo-Carmona. Polígono Nueva Ciudad, s/n. 06800 Mérida. España.
Unidad de Reumatología. Hospital General de Mérida. España
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Bibliografía
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Objetivo

Conocer si la fibromialgia (FM) se asocial un aumento de comorbilidad del tipo infecciones y enfermedades neoplásicas y cardiovasculares, y a un aumento de la mortalidad.

Material y métodos

Revisión sistemática. Se seleccionaron, mediante una estrategia sensible, todos los estudios publicados en PubMed (desde 1961), Embase (desde 1991), Cochrane Library Plus y resúmenes de congresos de reumatología (ACR y EULAR, desde 1999) hasta mayo de 2005. Se incluyeron estudios de cohortes, descriptivos y comparativos. Se depuró el resultado de la búsqueda mediante revisión de los títulos y los resúmenes.

Resultados

De 562 referencias proporcionadas por la búsqueda, se seleccionaron 33 estudios potenciales. Los pacientes con FM refieren una mayor comorbilidad y utilización de recursos médicos que la población general y que los pacientes con otras enfermedades reumáticas. La FM es más frecuente en pacientes hospitalizados y en el seno de infecciones por el virus de la inmunodeficiencia humana (VIH) y el virus de la hepatitis C (VHC). Algunos estudios encuentran un riesgo elevado de desarrollar cáncer en pacientes con FM. Diversos estudios han encontrado una tasa aumentada de mortalidad en FM, principalmente por cáncer y suicidios.

Conclusiones

A pesar de la elevada comorbilidad y utilización de los recursos médicos expresados por los pacientes con FM, no hay evidencia de que la FM se asocie a un aumento de comorbilidad por enfermedades cardiovasculares o infecciones. La asociación entre FM e infección por VHC o VIH indica la existencia de una posible relación entre FM e infección viral crónica. Los pacientes con dolor crónico generalizado pueden tener un riesgo aumentado de desarrollar cáncer. Parece que la FM puede llevar asociado también un riesgo aumentado de muerte accidental y por cáncer.

Palabras clave:
Fibromialgia
Pronóstico
Comorbilidad
Cáncer
Infecciones
Enfermedad cardiovascular
Mortalidad
Objective

To determine whether fibromyalgia (FM) is associated with an increase in comorbidity (infections, neoplastic and cardiovascular disease) as well as with an increase in mortality.

Material and methods

We performed a systematic review. Using a sensitive search strategy, all studies published in PubMed (from 1961), Embase (from 1991), Cochrane Library Plus and abstracts of rheumatology congresses (ACR and EULAR, from 1999) until May 2005 were selected. Cohort, descriptive and comparative studies were selected. The results of the search were screened through a review of the titles and abstracts.

Results

Of the 562 references retrieved by the search, 33 potentially relevant studies were selected. Patients with FM showed greater comorbidity and medical resource use than did the general population and patients with other rheumatic diseases. FM was more frequent in hospitalized patients and in the context of HIV and hepatitis C infections. Some studies found a high risk of developing cancer in FM patients. Several studies found an increased mortality rate in FM, mainly due to cancer and suicide.

Conclusions

Despite the high comorbidity and medical resource use in FM, there is no evidence that this entity is associated with an increase in comborbidity due to cardiovascular disease or infections. The association between FM and HIV and hepatitis C virus infections suggests a possible relationship between FM and chronic viral infection. Patients with chronic generalized pain may have an increased risk of developing cancer. FM may also carry an increased risk of accidental death and death from cancer.

Key words:
Fibromyalgia
Prognosis
Comorbidity
Cancer
Infections
Cardiovascular disease
Mortality
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Copyright © 2005. Elsevier España S.L. Barcelona
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Reumatología Clínica

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