Difference between Lupus and Fibromyalgia

Systemic lupus erythematosus or SLE or lupus is a chronic, autoimmune systemic disorder. It’s a disorder affecting the joints, skin, bone, heart, kidneys and nervous organs of the body. It leads to widespread inflammation.

Fibromyalgia, on other hand, is a disease affecting primarily various muscles of the body causing aches and soreness leading to tenderness at small points, extreme tiredness, sleep disturbances and anxiety with depression. Thus, it’s a type of muscular rheumatism without the involvement of bones and joints and without any underlying widespread inflammation.

Patients suffering from lupus may also suffer from fibromyalgia as it develops in a well established lupus disease, but fibromyalgia doesn’t develop into lupus.

Difference in causes

Lupus is an autoimmune systemic disorder, a condition in which the body fails to differentiate foreign cells from its own cells. This result in making antibodies directed against one’s own body’s cells called as auto-antibodies.

Fibromyalgia has a genetic linkage and this chronic disorder is found to be triggered by stress, anxiety, emotional trauma etc. The exact cause is yet unknown.

Difference in Symptoms-

Lupus being a systemic disease affects every system of the body. Some symptoms which lead to a definite diagnosis of the disorder are as follows.

• Arthritis- joint pains involving two or more joints.
• Photosensitivity– skin reaction on exposure to sunlight.
• Malar rash- erythematous rashes (redness) over the cheeks.
• Proteinuria which is more than 0.5 gm/day of protein in urine.
• Other signs include recurrent oral ulcers, depressed white blood cell count, lymphocytes and platelet count.

Fibromyalgia is a muscular condition and the symptoms include muscular aches with generalized fatigue, disturbed sleep, constant bodyache over well-defined small spots. The diagnosing factor is the identification of tender points on physical examination. Along with these symptoms, headaches, cold intolerance and restless leg syndrome are other symptoms commonly seen in association with it.

Diagnosis-

Fibromyalgia is a disease which is diagnosed mainly on a clinical basis and presenting symptoms of the patient. The tender points noted on physical examination confirms the diagnosis. In cases of lupus, a complete blood count reveals low WBCs less than 4000cells/cumm, anemia, high ESR, and low platelet count less than 100,000/cumm. Other confirmatory tests include a positive ANA (antinuclear antibodies) test and anti- DNA test which are both negative in cases of fibromyalgia as these are seen to be elevated only in cases of autoimmune disorders with inflammation.

Treatment-

Treatment in cases of lupus consists mainly of steroidal therapy with immunosuppressant drugs such as azathioprine, methotrexate or cyclophosphamide. Fibromyalgia on other hand does not respond to steroidal and immunosuppressant drugs and it requires a multi dimensional approach. Management mainly consists of symptomatic treatment including pain killers, anti depressants, and muscle relaxants.

Summary-

Lupus and fibromyalgia are different medical conditions affecting very different systems in the body. Lupus is a multi system disorder affecting all organs in the body whereas fibromyalgia is mainly a musculoskeletal disorder with rheumatic pains as the primary concern. In lupus, the diagnostic criteria lie in the skin sensitivity with a discoid rash along with joint pains whereas in fibromyalgia it’s the tender points of pain that is confirmatory for the diagnosis. Also, the tests such as ANA and anti- DNA are positive in cases of lupus and negative for fibromyalgia.

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