FIBROMIALGYA: CAUSES

FIBROMIALGYA

TYPE III HIPERTSENSITIVITY REACTION

INMUNE COMPLEXES DISEASE

Jaime Arango Hurtado M. D.

Surgeon - Magister in Epidemiology - University of Antioquia - Colombia South America
jarangoh77@yahoo.com

Chronic clinic picture, months or years of evolution, characterized by general malaise, headache, musculoskeletal pain, polyarthralgia, lumbar pain, and pelvic pain.

Common diagnoses

Fibromyalgia, Nonspecific Arthritis, Non-specific Myositis, Hypochondriasis, Depression Anxiety Disorder, and Chronic Fatigue Syndrome.

In the clinical history of these patients, in addition to the consultation for pain, there are frequent consultations for respiratory infection such as acute and chronic sinusitis, acute and chronic tonsillitis, acute and chronic otitis, turbinate hypertrophy, nasal congestion.

Findings on physical examination

Pressure pain in the sinuses.

 Signs of chronic ear infection.

Hypertrophic congestive tonsils, hypertrophy of nasal turbinate, nasal congestion, chronic rhinitis.

Pain on palpation in musculoskeletal structures.

Pain on pelvic palpation.

Palpation pain in the renal fossa.

Chronic respiratory infection favors the formation of antigen-antibody complexes (immune complexes) which, when not removed by the reticuloendothelial system, are deposited in different tissues:  joint structures, skeletal muscle system, basement membrane of the renal glomerulus, endothelium of small vessels.

Immune disorders develop when immune complexes are deposited pathologically in different organs, initiating a cascade of inflammatory processes that produce organic damage. Immune complexes are deposited on the articular surfaces, skeletal muscle system, renal glomerular basement membranes and vascular basement membranes and produce immunologically mediated inflammation, activation of humoral or cellular effector mechanisms, complement activation, vasoactive peptide release, release of Chemotactic factors, neutrophil accumulation, and release of lysosomal enzymes, with consequent inflammation of basal vascular membranes, inflammation of joint surfaces, inflammation of the skeletal muscle system, inflammation of the basement renal glomerular membrane, inflammation of the pelvic structures, injury Cellular, tissue injury, tissue injury.

The pain clinic picture described in this group of patients is due to a process of chronic inflammation, immunologically mediated inflammation. Type III hypersensitivity disorder. Immunocomplex disease. What we have named CHRONIC POLYARTICULAR AND MUSCULOESKELETAL PAIN SYNDROME,   a disease with a clear picture of signs and symptoms. With a clear pathophysiology: disease of immune complexes. Target organs: joint structures, kidneys (glomerular basement membrane) musculoskeletal system, basement membranes of small vessels.

This is a disease by immune complexes described from the clinical observation which may be included in the list of type III hypersensitivity reactions

References

1)      Harrison, Principles of Internal Medicine, McGraw Hill, Inc. p. 451. 1977

2)      Harrison, Principles of Internal Medicine, McGraw Hill, Inc. Chap 75. Pages 478-483

3)      Manual Merck, Immunology and Allergy, chap. 2. ninth Spanish edition 1994

4)      Roitt, Ivan. Immunology Fundamentals, seventh edition 1994, Pan American Medical Publishing, Ch. 6., chap. 7. chap. 10.

Presentations

(I) Acute pain management symposium, Harvard medical school (Boston, Sept. 2013)

(II) 24th meeting of American academy of pain management, (Orlando Fla. Sept. 2013)

(III) IV congress of pain medicine and palliative care, (Guayaquil, Ecuador, May 2013).

(IV) Medellin Academy of Medicine (Med. January 2014).

(V) Women's health conference, (Chicago, ill.) July 2014)

(VI) 2nd International Congress of Research in Health Sciences (Corpas-university-Colombia) November 2016

Jaime Arango Hurtado

Cel: 313 619 65 52

Email: jarangoh77@yahoo.com