Basic Lab Tests and Special Tests

From Fibro Wiki
Jump to: navigation, search

According to the Canadian guidelines, they make the following statement:

“No laboratory investigation confirms a clinical diagnosis of FM and unnecessary investigations which may be detrimental to patient well-being should be avoided. FM is not a diagnosis of exclusion [67]. Simple laboratory testing should be limited to a complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), thyroid stimulating hormone (TSH), and creatine kinase to rule out conditions that can present similarly to FM. These may include endocrine disease (hypothyroidism), rheumatic conditions (early inflammatory arthritis or polymyalgia rheumatica) or neurological disease (myopathy, or multiple sclerosis), depending upon the clinical evaluation. Appropriate additional testing, which might include referral for sleep evaluation, or formal psychological evaluation may be required in selected patients.

Reduced levels of vitamin D or vitamin D supplementation have no effect on pain in FM [68-70]. A positive antinuclear antibody (ANA) in low titre, present in 8-11% of FM patients, similar to healthy controls, does not predict future connective tissue disease [71- 73]. As no consistent abnormality has been identified in immune function, any screening should only be driven by clinical findings [74-76].” (Canadian Guidelines for the Diagnosis and Management of Fibromyalgia Syndrome, Mary-Ann Fitzcharles1,2, Peter A. Ste-Marie2,3, Don L. Goldenberg4, John X. Pereira5, Susan Abbey6, Manon Choinière7, Gordon Ko8, Dwight Moulin9, Pantelis Panopalis1, Johanne Proulx10, Yoram Shir2 2012 (See: http://fmguidelines.ca/ and http://fmguidelines.ca/?page_id=19.)