Lupus Fibromyalgia: The Ultimate Challenge

Many think of lupus and fibromyalgia as two different, distinct medical syndromes, and indeed they are. Each has a certain set of symptoms and treatments; in fact, rheumatologists sometimes say that the presence of fibromyalgia interferes with the correct diagnosis and treatment of lupus. These two conditions can be co-existing, complicating treatment for each. Lupus, fibromyalgia, scleroderma and rheumatoid arthritis are referred to as branches stemming from the same tree.

Linking Lupus and Fibromyalgia

Lupus fibromyalgia, Sjogren’s syndrome (excessive dryness of the eyes and mucous membranes), chronic fatigue syndrome, and systemic lupus erythematosus are all considered to be capable of co-existing. Specifically, both lupus and fibromyalgia are connective tissue diseases and auto-immune disorders. Although they both have similar symptoms and also differing symptoms the lines between these conditions is often quite thin.
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Systemic lupus and fibromyalgia share many commonalities: intense muscle, joint, and connective tissue pain, peripheral neuropathy, sensitivity to heat and cold, a low immunity to viruses of opportunity such as the flu, severe fatigue, sleep disturbances and an inability at times to focus and concentrate, called “brain fog.”
Many rheumatologists refer to fibromyalgia as sub-clinical systemic lupus. Aside from two key symptoms present in lupus, these two conditions can often be indistinguishable. Systemic lupus is definitively diagnosed based upon the infamous “butterfly rash” on the chest or face, and a lab test called a “sed rate” test.
Sufferers of fibromyalgia tend to have the same fear; that they will “convert over” to lupus. Thus, they watch constantly for the butterfly-shaped rash, knowing full well what this would mean for their health. When only these two symptoms are absent, these sufferers are classified as having lupus fibromyalgia.
This diagnosis, however, remains controversial among rheumatologists and immune disorder medical experts. For many, the patient has either lupus or fibromyalgia, not both. Lupus is primarily treated with strong steroid drugs such as Prednisone to reduce the pain and swelling of muscles, joints and connective tissues.
Long-term steroid use causes Cushing’s disease, a serious disorder of the thyroid and/or adrenal gland. Lupus also causes hair to thin drastically or be lost altogether. Fibromyalgia is very similar to lupus in symptomology, but physicians are reluctant to treat it with steroids, choosing other medications and therapies that don’t involve such serious side effects.
Ultimately, when a patient is asked if he/she has lupus or fibromyalgia, their most common answer is “I have lupus fibromyalgia.” As medical researchers continue to debate this issue, sufferers merely do what they can to treat the symptoms and leave the controversy to others.

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