Differential Diagnosis of Fibromyalgia

Differential Diagnosis of Fibromyalgia

What other conditions must be considered (ruled out) in a patient presenting with FM-like symptoms?

• Rheumatologic: RA, SLE, systemic sclerosis, Sjogren’s, polymyositis, polymyalgia rheumatica, AS.

• Endocrine: hypothyroidism, adrenal insufficiency, hyperparathyroidism, osteomalacia.

• Myopathy: metabolic, statin-induced, myotonic dystrophy.

• Gastrointestinal: hepatitis C, celiac, hemochromatosis, inflammatory bowel disease.

• Infections: subacute bacterial endocarditis, Lyme, human immunodeficiency virus, parvovirus, brucellosis.

• Neurologic: multiple sclerosis, myasthenia, peripheral neuropathy, small fiber neuropathy.

• Malignancy: metastatic, lymphoma, others.

• Sleep apnea.

• Psychiatric: major depression, substance abuse, eating disorders, somatoform disorders (see Question 10)

• Others: Chiari malformation, Fabry disease, chronic fatigue syndrome (systemic exertion intolerance disease).


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