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Posted to Co-Cure Sat, 18 Mar 2000 22:10:34 -0500

Co-existence of chronic fatigue syndome with fibromyalgia

Co-existence of chronic fatigue syndome with fibromyalgia syndrome in the general population. A controlled study.
Authors: White KP, Speechley M, Harth M, Ostbye T
Affiliation: Department of Medicine, University of Western Ontario, London, Canada.
Scandinavian Journal of Rheumatology (ISSN 0300-9742) 2000;29(1):44-51
NLM citations: PMID: 10722257, UI: 20185332

Using the 1988 CDC criteria for CFS, the authors found a significant clinical overlap between CFS and FMS.

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Posted to Co-Cure Sat, 18 Mar 2000 21:02:17 -0500

Autonomic dysfunction in patients with fibromyalgia

Autonomic dysfunction in patients with fibromyalgia: application of power spectral analysis of heart rate variability.
Authors: Cohen H, Neumann L, Shore M, Amir M, Cassuto Y, Buskila D
Affiliation: Ministry of Health Mental Health Center, Faculty of Health Sciences, Anxiety and Stress Research Unit, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Seminars in Arthritis and Rheumatism (ISSN 0049-0172) 2000 Feb;29(4):217-27
NLM citations: PMID: 10707990, UI: 20170263

The authors assessed interaction between the sympathetic and parasympathetic systems in 22 patients with fibromyalgia and 22 healthy controls, using power spectrum analysis (PSA) of heart rate variability (HRV). In addition, they explored "the association between HRV, measures of tenderness, FM symptoms, physical function, psychological well being and quality of life." The dysregulation they found in the FMS patients is discussed.

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Posted to Co-Cure Fri, 17 Mar 2000 19:18:11 -0500

Scientists decipher genetic code for "Chlamydia" species

[Note: This may be of interest to those concerned about CFS because of some reports associating C. pneumoniae with CFS.]

National Institute of Allergy and Infectious Diseases


Wednesday, March 15, 2000

Sam Perdue
(301) 402-1663


Researchers supported by the National Institute of Allergy and Infectious Diseases (NIAID) have determined the complete genetic blueprints for two unusual bacteria that cause a number of common diseases. One of these bacteria also has been implicated in chronic disorders such as heart disease, an active area of ongoing research.

In the March 15 issue of "Nucleic Acids Research", scientists from the United States and Canada report the complete DNA sequences of strains of "Chlamydia trachomatis" and "C. pneumoniae"(1). Both species live inside host cells, a property that distinguishes them from most other bacteria, but they differ from each other in the diseases they cause. "C. trachomatis" causes trachoma, a preventable form of blindness in infants, and infections of the genital tract in adults. "C. pneumoniae" causes pneumonia, bronchitis and, more rarely, sore throats and sinus infections. This microbe has also received increased attention because of reports suggesting it might be linked to cardiovascular disease. Limited studies also suggest a possible role for "C. pneumoniae" in other chronic disorders such as Alzheimer's disease, arthritis and asthma, but more research is needed in these areas.

Two previous studies, one funded by NIAID, uncovered the first genetic blueprints for one strain each of "C. trachomatis" and "C. pneumoniae".(2,3) By comparing their genetic organization, researchers have determined which genes are likely to be important for the different disease- causing properties of these two species.

The latest DNA sequences provide genetic information on two additional strains of the bacteria, one of each species. Because two strains of the same species - "C. pneumoniae", for example -- can differ in their ability to cause illness, such a comparison is critical to identifying the Strain-specific genes responsible for different types of disease.

As scientists further examine the connection between "C. pneumoniae" and chronic illnesses, this new sequence information may help in developing assays for detecting the presence of the microbe or its components in individuals and in establishing whether there is a connection between "C. pneumoniae" infection and the development of heart disease.

The recent genome sequencing projects were directed by Claire M. Fraser, Ph.D., of The Institute for Genomic Research in Rockville, Maryland, with researchers from the University of British Columbia Centre for Disease Control and the University of Manitoba. The previously reported Chlamydia sequence research was directed by Richard S. Stephens, Ph.D., of the University of California, Berkeley, in collaboration with researchers from the University of California at San Francisco, Stanford University and the National Institutes of Health.

Press releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at

The National Institute of Allergy and Infectious Diseases is a component of the National Institutes of Health, U.S. Department of Health and Human Services.

1. TD Read et al. Genome sequences of "Chlamydia trachomatis" MoPn and "Chlamydia pneumoniae" AR39. "Nucleic Acids Res" 28:1397-1406 (2000).

RS Stephens et al. Genome sequence of an obligate intracellular pathogen of humans: "Chlamydia trachomatis". "Science" 282:754-59 (1998).

S Kalman et al. Comparative genomes of Chlamydia pneumoniae and "C. trachomatis". "Nature Genet" 21:385-89 (1999).

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Posted to Co-Cure Mon, 13 Mar 2000 22:28:58 -0500

Trauma and fibromyalgia: is there an association and what does it mean?

Trauma and fibromyalgia: is there an association and what does it mean?
Authors: White KP, Carette S, Harth M, Teasell RW
Affiliation: Department of Medicine, University of Western Ontario, London, Canada.
Journal: Seminars in Arthritis and Rheumatism (ISSN 0049-0172) 2000 Feb;29(4):200-16
NLM citations: PMID: 10707989, UI: 20170262

After a review of current research, the authors concluded that while some studies find an increased risk for fibromyalgia in people who have had physical trauma, there is still the need for additional studies to determine whether such a connection exists, and if it does, whether it is the trauma itself or other factors which may be the causal factors responsible for FM symptoms following acute injury.

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Posted to Co-Cure Wed, 8 Mar 2000 13:28:01 -0500 by Kimberly Hare

Elevated plasma levels of neuropeptide Y in female fibromyalgia patients

Elevated plasma levels of neuropeptide Y in female fibromyalgia patients.
Eur J Pain 1999 Mar;3(1):19-30
Anderberg UM, Liu Z, Berglund L, Nyberg F
Department of Neuroscience and Psychiatry, Uppsala University, SE-751 85, Uppsala, Sweden
PMID: 10700334

Neuropeptide Y(NPY) co-exists with norepinephrine in the sympathetic nervous system, and NPY may represent the sympathetic-neuronal output. Fibromyalgia syndrome (FMS) patients have perturbations in the hypothalmic-pituitary-adrenal (HPA) axis and in the sympathetic stress axis as well.

As opioid peptides, monoamines and sex steroids are integrated in the regulation of stress, it is interesting to further explore the role of NPY in FMS patients, as they show many symptoms that are related to perturbations of those systems.

In this study, plasma NPY levels were assessed in subgroups of FMS patients: cyclic (regular menstrual cycles), non-cyclic (post-menopausal), depressed and non-depressed patients. In order to examine whether pain and other symptoms seen in FMS patients are correlated to the NPY levels, the patients were also registering 15 different symptoms daily during 28 days. Sex and age-matched healthy controls were recruited for comparisons. Non-parametric tests were used for the statistical analyses.

The results showed that the NPY levels were significantly elevated in the patients compared to the controls. In the luteal phase of the cyclic patients, the levels of the peptide were higher than in the corresponding controls. For the non-cyclic patients, there was a positive correlation between physical symptoms and NPY levels, however, pain per se did not reach the significant level of correlation. The non-depressed patients had the same levels of NPY as the depressed FMS patients, who also had a positive correlation between anxiety and NPY levels.

These results suggest that FMS patients have an altered activity in the NPY system, most likely due to prolonged and/or repeated stress, and that the hormonal state and time of the menstrual cycle also may be of importance in the complex pathophysiologic mechanism behind the development of FMS.

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Posted to Co-Cure Wed, Wed, 8 Mar 2000 13:21:23 -0500 by Kimberly Hare

Connective tissue massage in the treatment of fibromyalgia

Connective tissue massage in the treatment of fibromyalgia.
Eur J Pain 1999 Jun;3(3):235-244
Brattberg G
Department of Research and Development, County Council of Gavleborg, Gavle, University Hospital, Uppsala, Sweden
PMID: 10700351

The aim of this study was to investigate the effect of connective tissue massage in the treatment of individuals with fibromyalgia. The results of this random study of 48 individuals diagnosed with fibromyalgia (23 in the treatment group and 25 in the reference group) show that a series of 15 treatments with connective tissue massage conveys a pain relieving effect of 37%, reduces depression and the use of analgesics, and positively effects quality of life.

The treatment effects appeared gradually during the 10-week treatment period. Three months after the treatment period about 30% of the pain relieving effect was gone, and 6 months after the treatment period pain was back to about 90% of the basic value. As long as there is a lack of effective medical treatment for individuals with fibromyalgia, they ought to be offered treatments with connective tissue massage.

However, further studies are needed in the mechanisms behind the treatment effects.

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Posted to Co-Cure Wed, 8 Mar 2000 13:39:47 -0500 by Fred Springfield

Preference for nonsteroidal antiinflammatory drugs over acetaminophen ...

Preference for nonsteroidal antiinflammatory drugs over acetaminophen by rheumatic disease patients: a survey of 1,799 patients with osteoarthritis, rheumatoid arthritis, and fibromyalgia.
J: Arthritis Rheum 2000 Feb;43(2):378-85
Wolfe F, Zhao S, Lane N
Arthritis Research Center and University of Kansas School of Medicine, Wichita 67214, USA.   E-Mail:
PMID: 10693878, UI: 20155545

OBJECTIVE: Because there is controversy regarding the efficacy of acetaminophen in rheumatic diseases and because apparently safer nonsteroidal antiinflammatory drugs (NSAIDs) are being produced, we surveyed rheumatic disease patients about their preferences for these agents to determine the degree to which one type of therapeutic agent is preferred over the other.

METHODS: In 1998, we surveyed by mailed questionnaire 1,799 patients with osteoarthritis (OA), rheumatoid arthritis, or fibromyalgia who were participating in a long-term outcome study. Patients who had taken acetaminophen rated the effectiveness of acetaminophen, compared its effectiveness with that of NSAIDs, and then rated their overall satisfaction with acetaminophen compared with NSAIDs when both effectiveness and side effects were considered.

RESULTS: Two-thirds of study participants had taken acetaminophen. About 37% of patients who had taken acetaminophen found it to be moderately or very effective and about 63% indicated that it was not effective or was only slightly effective. One-fourth of the patients found acetaminophen and NSAIDs to be equally effective, but >60% found acetaminophen to be much less effective or somewhat less effective. About 12% preferred acetaminophen to NSAIDs. When both effectiveness and side effects were considered together, 25% of the patients had no preference, 60% preferred NSAIDs, and 14% preferred acetaminophen.

CONCLUSION: There was a considerable and statistically significant preference for NSAIDs compared with acetaminophen among the 3 groups of rheumatic disease patients. Although this preference decreased slightly with age and was less pronounced in OA patients, the preference was noted among all categories of patients and was not altered by disease severity. If safety and cost are not issues, there would hardly ever be a reason to recommend acetaminophen over NSAIDs, since patients generally preferred NSAIDs and fewer than 14% preferred acetaminophen. If safety and costs are issues, then the recommendation of the American College Rheumatology that acetaminophen be tried first seems correct, since 38.2% found acetaminophen to be as effective or more effective than NSAIDs.

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Posted to Co-Cure Wed, 8 Mar 2000 13:43:02 -0500 by Fred Springfield

Functional anatomy of hypnotic analgesia: a PET study of patients with FM

Functional anatomy of hypnotic analgesia: a PET study of patients with fibromyalgia.
Eur J Pain 1999 Mar;3(1):7-12
Wik G, Fischer H, Bragee B, Finer B, Fredrikson M
Department of Clinical Neurosciences, Karolinska Institute and Hospital, Stockholm, Sweden
PMID: 10700332

Hypnosis is a powerful tool in pain therapy. Attempting to elucidate cerebral mechanisms behind hypnotic analgesia, we measured regional cerebral blood flow with positron emission tomography in patients with fibromyalgia, during hypnotically-induced analgesia and resting wakefulness.

The patients experienced less pain during hypnosis than at rest. The cerebral blood-flow was bilaterally increased in the orbitofrontal and subcallosial cingulate cortices, the right thalamus, and the left inferior parietal cortex, and was decreased bilaterally in the cingulate cortex.

The observed blood-flow pattern supports notions of a multifactorial nature of hypnotic analgesia, with an interplay between cortical and subcortical brain dynamics.

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Posted to Co-Cure Wed, 8 Mar 2000 13:52:37 -0500 by Fred Springfield

Pain and allodynia/hyperalgesia induced by intramuscular injection of serotonin in patients with fibromyalgia and healthy individuals

Pain and allodynia/hyperalgesia induced by intramuscular injection of serotonin in patients with fibromyalgia and healthy individuals.
J: Pain 2000 Mar 1;85(1-2):31-39
Ernberg M, Lundeberg T, Kopp S
Department of Clinical Oral Physiology, Institute of Odontology, Box 4064, S-141 04, Huddinge, Sweden
PMID: 10692600

The aim of this study was to investigate the effect of injection of serotonin (5-HT) into the masseter muscle on pain and allodynia/hyperalgesia.

Twelve female patients with fibromyalgia (FM) and 12 age-matched female healthy individuals (HI) participated in the study. The current pain intensity (CPI) and the pressure pain threshold (PPT) of the superficial masseter muscles were assessed bilaterally.

5-HT in one of three randomized concentrations (10(-3), 10(-5), 10(-7) M) or isotonic saline was then injected into either of the two masseter muscles in a double-blind manner. After the injections the CPI and PPT were recorded ten times during 30 min.

The injections were repeated twice with the other concentrations of 5-HT after 1 and 2 weeks, respectively.

In the FM-group there was a non-significant increase of CPI after injection that lasted during the entire 30-min period irrespective of whether 5-HT or saline was injected. Neither did the PPT change significantly. In the HI-group pain developed significantly after injection irrespective of whether 5-HT or saline was injected, but significantly more so after 5-HT at 10(-3) M than saline injection. CPI decreased quickly and then remained on a very low level for most of the experiment. 5-HT at both 10(-5) M and 10(-3) M caused a significantly greater decrease of PPT than saline.

In conclusion, our results show that 5-HT injected into the masseter muscle of healthy female subjects elicits pain and allodynia/hyperalgesia, while no such responses occur in patients with fibromyalgia.

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Posted to Co-Cure Wed, 8 Mar 2000 11:41:25 -0500 by Fred Springfield

Chronic Fatigue Syndrome in Patients with Lyme Borreliosis

Chronic Fatigue Syndrome in Patients with Lyme Borreliosis.
J: Eur Neurol 2000 Feb;43(2):107-109
Treib J, Grauer MT, Haass A, Langenbach J, Holzer G, Woessner R
Department of Neurology, University Hospital of the Saarland, Homburg,
Germany. PMID: 10686469

Several authors have reported a chronic fatigue-like syndrome in patients that have suffered from Lyme borreliosis in the past. To further investigate this suspicion of an association without sample bias, we carried out a prospective, double-blind study and tested 1,156 healthy young males for Borrelia antibodies.

Seropositive subjects who had never suffered from clinically manifest Lyme borreliosis or neuroborreliosis showed significantly more often chronic fatigue (p = 0.02) and malaise (p = 0.01) than seronegative recruits. Therefore we believe it is worth examining whether an antibiotic therapy should be considered in patients with chronic fatigue syndrome and positive Borrelia serology.

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Posted to Co-Cure Tue, 7 Mar 2000 10:41:27 -0500 by Fred Springfield

CFS and/or FM as a variation of antiphospholipid antibody syndrome

J: Blood Coagul Fibrinolysis 1999 Oct;10(7):435-8
Chronic fatigue syndrome and/or fibromyalgia as a variation of antiphospholipid antibody syndrome: an explanatory model and approach to laboratory diagnosis.
Berg D, Berg LH, Couvaras J, Harrison H
HEMEX Laboratories, Inc., Phoenix, Arizona 85021, USA.
PMID: 10695770, UI: 20158317

Chronic Fatigue and/or Fibromyalgia have long been diseases without definition. An explanatory model of coagulation activation has been demonstrated through use of the ISAC panel of five tests, including, Fibrinogen, Prothrombin Fragment 1+2, Thrombin/ AntiThrombin Complexes, Soluble Fibrin Monomer, and Platelet Activation by flow cytometry.

These tests show low level coagulation activation from immunoglobulins (Igs) as demonstrated by Anti-B2GPI antibodies, which allows classification of these diseases as a type of antiphospholipid antibody syndrome. The ISAC panel allows testing for diagnosis as well as monitoring for anticoagulation protocols in these patients.

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Posted to Co-Cure Thu, 24 Feb 2000 09:31:26 -0500

Fibromyalgia in men: comparison of clinical features with women

Fibromyalgia in men: comparison of clinical features with women.
Authors: Yunus MB, Inanici F, Aldag JC, Mangold RF
Affiliation: Department of Medicine, University of Illinois, College of Medicine at Peoria, 61656, USA.  E-Mail:
Journal of Rheumatology 2000 Feb;27(2):485-90
NLM citations: PMID: 10685818, UI: 20148254

The authors found that male patients with FM had fewer symptoms and fewer tender points, and less common "hurt all over," fatigue, morning fatigue, and IBS, compared with female patients.

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Posted to Co-Cure Tue, 15 Feb 2000 21:54:55 -0500

Seasonal onset of CFS points to infectious, not psychiatric, trigger

Chronic fatigue syndrome beginning suddenly occurs seasonally over the year.
Authors: Zhang QW, Natelson BH, Ottenweller JE, Servatius RJ, Nelson JJ, Luca JD, Tiersky L, Lange G
Affiliation: Department of Neurosciences, University of Medicine and Dentistry-New Jersey Medical School, Newark, USA.
Journal: Chronobiology International (ISSN 0742-0528) 2000 Jan;17(1):95-9
NLM citations: PMID: 10672437, UI: 20136368

The authors suggest that for CFS to be a psychiatric disorder related to symptom amplification, onset would occur randomly over the calendar year. Their study of 69 seriously ill patients with sudden onset indicates just the opposite: dates of onset which were distinctly non-random.

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Posted to Co-Cure Sat, 12 Feb 2000 00:58:45 -0800 by Melissa O'Toole

Examination of Cloninger's basic dimensions of personality in fatiguing illness

J Psychosom Res 1999 Dec;47(6):597-607
Examination of Cloninger's basic dimensions of personality in fatiguing illness: chronic fatigue syndrome and multiple sclerosis.
Christodoulou C, Deluca J, Johnson SK, Lange G, Gaudino EA, Natelson BH
University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA.
PMID: 10661606, UI: 20125248

Relatively few studies have examined the personality characteristics of patients with chronic fatigue syndrome (CFS).

The personality profiles of 38 CFS subjects were compared with 40 healthy controls and 40 subjects with multiple sclerosis (MS), a chronic illness that shares many symptoms with CFS (e.g., fatigue), but has a known neurological substrate.

Subjects were examined within Cloninger's biosocial theory of personality, which delineates basic dimensions of temperament. Both illness groups displayed similarly elevated levels of Harm Avoidance, and lower levels of Reward Dependence as compared with healthy controls.

The MS group showed a lower level of Persistence than controls and CFS subjects. Implications for the relationship between chronic illness and personality are discussed.

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Posted to Co-Cure Fri, 11 Feb 2000 20:27:04 -0500

Muscle performance in fibromyalgia syndrome

Muscle performance in fibromyalgia syndrome.
Authors: Borman P, Celiker R, Hascelik Z
Affiliation: Hacettepe University Department of Physical Medicine & Rehabilitation, Ankara, Turkey.   E-Mail:
Rheumatology International (ISSN 0172-8172) 1999;19(1-2):27-30
NLM citations: PMID: 10651078, UI: 20114500

The authors studied muscle performance, isokinetic muscle strength, muscle endurance ratio, and submaximal aerobic performance in patients with fibromyalgia compared to control subjects. Maximal voluntary muscle strength of the quadriceps was significantly lower in patients; endurance ratios showing the work capacity were not statistically different; and submaximal aerobic performance scores were higher in the control group. The authors concluded that FMS patients have impaired muscle function.

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Posted to Co-Cure Wed, 9 Feb 2000 23:26:49 +0000 by Maggie Wallace

Bacterial Infection Can Lead to Autoimmune Diseases

[Moderator's Note: Many thanks to Terrye Newkirk for sending this to us. While not mentioning CFS/FMS, the described research indicates a possible relationship between prior infection and later disease.]

Hopkins: Salmonella’s Molecular Mimics May Spark Arthritis
February 1, 2000
BALTIMORE (Johns Hopkins) — Scientists at Johns Hopkins have uncovered an important link between getting specific bacterial infections and developing autoimmune diseases such as arthritis.

In a study reported in this month's edition of the journal Nature Medicine, the researchers show clearly that immune system cells that fight bacteria can also attack normal cells carrying a specific mimic molecule — one that closely resembles a bacterial protein.

Further, they show that as long as there's been a previous bacterial infection, immune cells can attack "innocent bystander" cells — body cells that bacteria have never infected. This occurs when the cells are stressed by exposure to irradiation, environmental toxins or the body's stress chemicals.

"We've found this evidence that the immune system can be fooled," says Mark Soloski, Ph.D, who led the research team, "and it suggests subtle changes that could underlie many autoimmune diseases." The study also offers a starting place for scientists to investigate environmental or genetic triggers to autoimmune diseases.

The team focused on infections by Salmonella, bacteria well known for food poisoning but also long thought to trigger arthritis in some people. "As many as 10 percent of those who get Salmonella develop a ‘reactive' kind of arthritis which lasts a few weeks," says Soloski. "But a smaller, significant number of those patients get a severe, debilitating type of arthritis that's long-lasting."

To investigate bacteria/arthritis connections, the scientists observed behavior of a typical bacteria-fighting immune cell, the cytotoxic lymphocyte (CTL), as it approached infected body cells. Cells invaded by bacteria normally give clear signals that they're infected. "They display small pieces of bacterial proteins on their surface that say, in effect, ‘Hey, here's a sick cell,'" says Soloski. Attracted by this protein "flag," CTLs dock with the infected cells and trigger their rapid self-destruction.

The Hopkins scientists first identified the protein "flag" in mouse cells infected with Salmonella as one common to certain bacteria associated with human arthritis, including Borrelia — the cause of Lyme disease.

But they also found the bacterial "flag" was almost identical to parts of a "universal housekeeping molecule" found in humans, mice and all living organisms. This "housekeeping molecule" helps proteins keep their shape.

When researchers artificially coaxed mouse body cells to display the Salmonella "flag," the mouse CTLs would readily attack them. But CTLs also went into attack mode if the cells displayed a piece of the mouse's own housekeeping molecule or the identical human version.

"This shows us the immune cells readily respond to a molecular mimic," says Soloski.

In a normal Salmonella infection in mice, Soloski says, "at least half of the CTLs are stirred up to recognize the mouse's own protein as well as the bacterial one. That's a huge immune response." Based on the similarity of the set-up in humans, he adds, the response is likely the same. Now the scientists are trying to find why and how this immune response translates into arthritis in some mice and humans.

In a small side study, the team also found that normal, uninfected body cells could be attacked by CTLs if the cells were stressed in some way, such as being exposed to higher temperature or radiation or general infection. "We don't know what's going on here," says Soloski, "but it's a good place to study other triggers of autoimmune diseases."

Other researchers were lead author Wei-Feng Lo, M.D., Ph.D., Amy DeCloux, Ph.D., Amina S. Woods, Ph.D., and Robert J. Cotter, Ph.D., of Hopkins, as well as Eleanor S. Metcalf, Ph.D., of the Uniformed Services University of the Health Sciences in Bethesda, Md.

The research was funded by NIH grants and by an award from the Maryland Chapter of The Arthritis Foundation.

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Posted to Co-Cure Wed, 9 Feb 2000 16:47:34 -0500

Incidence of keratoconjunctivitis sicca not increased in fibromyalgia population

Assessment of keratoconjunctivitis sicca in patients with fibromyalgia: results of a prospective study.
Authors: Gunaydin I, Terhorst T, Eckstein A, Daikeler T, Kanz L, Kotter I
Affiliation: Department of Rheumatology/Hematology, Eberhard-Karls-University, Tubingen, Germany.
Journal: Rheumatology International (ISSN 0172-8172) 1999;19(1-2):7-9
NLM citations: PMID: 10651073, UI: 20114495

[Note: Keratoconjunctivitis sicca (KCS) is a drying/inflammation of the clear membrane coating the inside of the eyelids and the outer surface of the eye. It is caused by insufficient tear production. KCS is one of the defining symptoms of sjogren's syndrome.]

The authors investigated the association and prevalence of keratoconjunctivitis sicca (KCS) in patients with FM using Schirmer's I test, break-up time, Rose-Bengal score, and a detailed ophthalmological examination. The authors concluded that their findings indicate the prevalence of KCS is not increased in patients with FMS and that the FMS population probably has objective ocular findings comparable with the normal population.

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Note: All abstract summaries, unless otherwise noted, were prepared by Margaret Bailey.

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