Naslov
The art of recognizing pain amplification syndrome in children

Autori
Vukić, Vana ; Vidović, Mandica ; Harjaček, Miroslav ; Lamot, Lovro

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
Archives of disease in childhood, 106 (2021), Suppl 2 / - , 2021, A188-A188

Skup
10th Congress of European Paediatric Association EPA/UNEPSA jointly held with 14 th Congress of Croatian Paediatric Society

Mjesto i datum
Zagreb, Hrvatska, 07.10.2021. - 09.10.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
juvenile fibromyalgia ; pain amplification syndrome ; multidisciplinary approach ; pediatrics

Sažetak
Juvenile fibromyalgia is a pain amplification syndrome characterized by diffuse idiopathic musculoskeletal pain, most frequently affecting children older than 10 years. Girls are more commonly affected than boys, with the ratio of 1: 4 – 8. American College of Rheumatology criteria for diagnosis include absence of other disorder that could explain the pain, symptoms lasting for ≥ 3 months, widespread pain index (WPI) ≥ 7 and symptom severity score (SSS) ≥ 5 or WPI 3 – 6 and SSS ≥ 9. We present a case of 15 years old girl with diffuse and persistent pain along with episodes of impaired consciousness. Those episodes occurred once a month for the last 3 years and were characterized by collapse and/or inability to move or speak for several minutes. They were preceded by paraesthesia of face, arms and feet, but have never resulted in injury. In addition, patient complained of pain in radiocarpal joints, hips, low back, groins and neck, along with extreme tiredness, poor sleeping and inability to concentrate. Extensive examination was undertaken. The neurological assessment included brain MRI and EEG, both of which were normal. The rheumatologic evaluation revealed multiple painful points with WPI 9 and SSS 8. The patient didn’t experience morning stiffness, joint swelling or fever. Extensive laboratory workup and MRI of sacroiliac joints along with a lumbar and thoracic portion of the spine excluded the inflammatory aetiology. The psychological assessment revealed poor stress coping strategies. The patient was diagnosed with fibromyalgia and conversion disorder manifested in the form of pseudoseizures. Physical therapy and psychotherapy were advised, along with melatonin for better sleep regulation, which led to a mild improvement of symptoms within a month. Fibromyalgia and diverse psychological distress are causally related. Accordingly, conversion symptoms are not uncommon. Therefore, a multidisciplinary team approach is necessary when caring for these patients, in addition to providing treatment not only for the affected individual but for the entire family as well.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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