Medical Health Encyclopedia

Autoimmune diseases generally evolve slowly. Even if a doctor determines that a patient is most likely to have fibromyalgia, he or she should keep track of any changes in symptoms over time in case one of these illnesses is actually present.

Lyme Disease. Early Lyme disease can usually be correctly diagnosed, but a delayed response or recurrence of this disorder may be mistaken for fibromyalgia. Some experts believe that between 15 - 50% of patients referred to clinics for Lyme disease actually have fibromyalgia. Late Lyme disease can usually (but not always) be ruled out using blood tests that identify the infectious organism that causes this tick-borne disease. If fibromyalgia patients are incorrectly diagnosed and treated for Lyme disease with prolonged courses of antibiotics, the drugs may have serious side effects.

Drugs and Alcohol. Fatigue is a side effect of many prescription and over-the-counter medications, such as antihistamines. In addition, dependency on or abuse of alcohol or illicit drugs may manifest as persistent fatigue. Medications should be considered as a possible cause of fatigue if an individual has recently started, stopped, or changed medications. Withdrawal from caffeine can produce depression, fatigue, and headache.

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Polymyalgia Rheumatica. Polymyalgia rheumatica is a condition that causes pain and stiffness and generally occurs in older women. Tender points are also present with this disorder, although they almost always occur in the hip and shoulder area. Morning stiffness is common, and patients may also experience fever, weight loss, and fatigue. High blood levels of erythrocyte sedimentation rates (ESR or sed rates) can suggest polymyalgia rheumatica. Elevated sed rates, however, also occur with other conditions. Polymyalgia rheumatica often resolves in about a year, but there is a risk of persistent disease. Worse, it is associated with a rare condition called temporal arteritis, which causes blindness if not healed, so an accurate diagnosis of polymyalgia rheumatica is important.

Other Diseases That May Rule Out Fibromyalgia.

• Hepatitis -- Hepatitis C, in fact, may prove to be a cause of some cases of fibromyalgia
• Anemia
• Diabetes
• Infections -- For example, infectious mononucleosis is marked by fatigue and swollen glands. It primarily affects adolescents and young adults. Some patients may have lingering fatigue that last for many months.
• Cancer
• Neuromuscular diseases such as myasthenia gravis