THU0472 FIBROMYALGIA SYNDROME IN WEST AFRICA: ACR 1990 IS NOT SENSITIVE FOR THE UNDER-DIAGNOSED AND WIDELY MISUNDERSTOOD DISORDER

Abstract

Background Like most poorly understood rheumatic conditions, Fibromyalgia is thought to be rare in West Africa. Many clinicians rely on the various ACR classification criteria to make a diagnosis of Fibromyalgia despite the unknown performance of these criteria among patients of sub-Saharan African origin. Objectives To describe the characteristics of fibromyalgia in Nigerian patients and determine the sensitivities of four ACR criteria sets. Methods Consecutive patients diagnosed with fibromyalgia for the first time by a rheumatologist were evaluated using ACR 1990, ACR 2010, 2011 modification of ACR 2010 (ACR 2011) and ACR 2016 classification criteria for fibromyalgia. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), fatigue with the Fatigue Severity Scale (FSS) and severity of fibromyalgia with the Revised Fibromyalgia Impact Questionnaire (FIQR). The overall characteristics and the beliefs of these patients regarding their disease were analysed. Results Of the one hundred and fourteen (114) patients, ninety six (96) were females; male-to-female ratio is 1:5.3. The median duration of symptoms before diagnosis is 54 months (3 to 273 months) and the mean age is 44.6±15.6 years. Mild, moderate, and severe fibromyalgia were found in 32(28.1%), 53(46.5%) and 29(25.4%) patients respectively. Sensitivities of ACR 1990, ACR 2010, ACR 2011, andACR 2016 were 38.5%, 68.2%, 76.7% and 76.7%, respectively. Poor sleep was found in 83 (72.8%) patients. Patients in functional classes I, II, and III were 71 (62.3%), 19 (16.7%) and 24 (21.1%), respectively. There was none in class IV. There was positive history of widespread pain in at least one first degree relative of 56 (49.1%) patients. Twenty-one (18.4%) patients had changed or quit their job due to the disease and there was significant association between job loss and number of tender points as well as disease severity. The Mean FFS score is 4.48±1.3 and 73 (64.0%) patients believed their problem is a spiritual attack while 43 (37.7%) had done one form of ritual or the other in search of cure. Conclusion Fibromyalgia syndrome exists in West Africa. It is poorly understood among the sufferers and ACR 1990 is not sensitive as a diagnostic tool for the condition. References [1] Bidari A, Ghavidel Parsa B, Ghalehbaghi B. Challenges in fibromyalgia diagnosis: from meaning of symptoms to fibromyalgia labeling. The Korean journal of pain. 2018 Jul;31(3):147-54. Disclosure of Interests None declared