Diagóstico de fibromialgia mediante exámen de sangre

The Fibromyalgia Blood Test

It hit the business wire a few weeks back a blood test which detects Fibromyalgia has been developed, registered with the FDA and is currently being sold. Holy shazam a-lam-a-ding-dong...WHAT! With rapt attention I poured over the clinical abstract and scientific research to get a grasp on what on earth had been unearthed. As it stands Fibromyalgia is a diagnosis of exclusion based on a collection of symptoms reported by the patient. There is no conclusive test to either confirm diagnosis or rule it out. Fibromyalgia symptoms vary drastically from patient to patient, people respond individually to different treatment methods and modern medicine is still searching for the cause and mechanism of all this mayhem. Well The University of Illinois College of Medicine at Chicago, in conjunction with a biomedical company EpicGenetics, says they have figured it out. "In the past, FM was claimed to be a rheumatic, neurologic or psychiatric disease despite the fact that there were no objective links to any of those pathways. Our findings uncovered evidence that FM is instead an immunologic disorder." BMC Clinical Pathology.

So what exactly is Fibromyalgia, according to this groundbreaking discovery? I desperately want to know what the hell caused my entire world to implode so I did a significant amount of research to figure out what this study revealed. In the simplest terms, protein molecules produced by white blood cells (cytokines) in Fibromyalgia patients suffer from a dysregulation disorder. They are supposed to send messages via an inflammation response to alert the body when something is wrong so the body can fix itself. Just one component of the immune system at work. But in Fibromyalgia patients these protein molecules are depressed. This immune development disruption makes Fibromyalgia patients more vulnerable to stress. And the perfect storm is set into motion... 

Now let me clarify the word stress here. This isn't stress as in, "Oh my God I am so stressed out!" It is stress like when a doctor tells a patient to come in for a "stress test." They are strapped with electrodes, hooked up to machines and made to run a marathon on a treadmill to measure the effect of stress on their body. Okay maybe not a marathon but you get my drift. A fundamental building block of physics discovered in 1660 called Hooke's Law explains stress as the distribution of external force on a material, resulting in strain. It wasn't until the 1920's stress became associated with psychological or biological mental strain. So let's dispel the confusion of the chicken or the egg. A person with Fibromyalgia has immune patterns already present that cause stress to wreak havoc on their nervous system. Yes, the "Oh my God I am so stressed out!" kind is a valid contributor, but so are a million other sources of external force on cells and molecules and peptides and lymphokines and whatever else exists inside a human body to make it a human body. Like I said, a perfect storm.

Clearly I am more impressed by the actual mechanism discovered unique to Fibromyalgia patients than any test which can tell me if I do or don't have it. Scanning the posts of my fellow bloggers tells me I am not alone in this skepticism. See cytokines have been a working theory of research for decades and are known offenders in a slew of other ailments. What this study gives us is the first way to actually measure a difference between Fibromyalgia patients and healthy or healthy/depressed controls. It's a big win, the first breadcrumb of a clue conclusively showing a scientific difference in Fibro patients. But like many things in life, conclusive proof opens up far more questions than provides answers. Is this immune dysregulation true for all people diagnosed with Fibromyalgia? All 12.3 million of us in the USA alone? How well does it differentiate between Fibromyalgia and RA, Lupus or a gazillion other immune disorders and chronic pain conditions? Is there enough information available to wrap it up with a bow and stock it on blood pathologists shelves? Perhaps time, and significantly more research on a greater population of patients, will tell. 

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