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).