Early-Stage Juvenile Fibromyalgia in a 12-Year-Old Girl

Yoshihiko Sakurai

Department of Pediatrics, Matsubara Tokushukai Hospital, Matsubara, Japan.

DOI: 10.4236/ojped.2015.54053                

Abstract

Juvenile fibromyalgia (JFM) is often diagnosed at a later stage. Therefore, little is known about its early phase. A 12-year-old girl with persistent lumbago without fever consulted an orthopedist, but imaging studies showed no abnormalities and analgesics were ineffective. She therefore visited our pediatric clinic. On digital palpation, she had pain in 13 of the 18 tender point sites of fibromyalgia. The blood test results were unremarkable. A medical interview revealed character tendencies often seen in patients with JFM; she was serious-minded, uncompromising, and showed excessive concern for others. Furthermore, psychological stress for the approaching annual sports day might have built up. All factors considered, early-stage JFM was the probable diagnosis. The patient accepted the diagnosis and understood that the disease may be psychogenic. Getting through the sports day cured her symptoms. This case highlights the importance of initial care, including a detailed explanation, in those with JFM.

Keywords

Juvenile Fibromyalgia, Early Stage, Character Tendency, Psychological Stress, Initial Care

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Hawkins, R.A. (2013) Fibromyalgia: A Clinical Update. The Journal of the American Osteopathic Association, 113, 680-689. http://jaoa.org/article.aspx?articleid=2094606 http://dx.doi.org/10.7556/jaoa.2013.034
[2]	Kashikar-Zuck, S. and Ting, T.V. (2014) Juvenile Fibromyalgia: Current Status of Research and Future Developments. Nature Reviews Rheumatology, 10, 89-96. http://www.nature.com/nrrheum/journal/v10/n2/pdf/nrrheum.2013.177.pdf http://dx.doi.org/10.1038/nrrheum.2013.177
[3]	Valente, A.M., Jain, R., Scheurer, M., Fowler, V.G.J., Corey, G.R., Bengur, A.R., Sanders, S. and Li, J.S. (2005) Frequency of Infective Endocarditis among Infants and Children with Staphylococcus aureus Bacteremia. Pediatrics, 115, e15-e19. http://pediatrics.aappublications.org/content/115/1/e15.long
[4]	Fuss, S., Page, G. and Katz, J. (2011) Persistent Pain in a Community-Based Sample of Children and Adolescents. Pain Research & Management, 16, 303-309. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206778/
[5]	King, S., Chambers, C.T., Huguet, A., MacNevin, R.C., McGrath, P.J., Parker, L. and MacDonald, A.J. (2011) The Epidemiology of Chronic Pain in Children and Adolescents Revisited: A Systematic Review. Pain, 152, 2729-2738. http://dx.doi.org/10.1016/j.pain.2011.07.016
[6]	Uziel, Y. and Hashkes, P.J. (2007) Growing Pains in Children. Pediatric Rheumatology Online Journal, 5, 5. http://dx.doi.org/10.1186/1546-0096-5-5
[7]	Yunus, M.B. and Masi, A.T. (1985) Juvenile Primary Fibromyalgia Syndrome. A Clinical Study of Thirty-Three Patients and Matched Normal Controls. Arthritis & Rheumatology, 28, 138-145. http://onlinelibrary.wiley.com/doi/10.1002/art.1780280205/pdf http://dx.doi.org/10.1002/art.1780280205
[8]	Wolfe, F., Smythe, H.A., Yunus, M.B., Bennett, R.M., Bombardier, C., Goldenberg, D.L., Tugwell, P., Campbell, S.M., Abeles, M., Clark, P., et al. (1990) The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis & Rheumatology, 33, 160-172. http://onlinelibrary.wiley.com/doi/10.1002/art.1780330203/pdf http://dx.doi.org/10.1002/art.1780330203
[9]	Yokota, S. (2009) Juvenile Fibromyalgia. In: Nishioka, K., Ed., Guidance for Diagnosis and Management, Medical Review, Tokyo, 75-82.
[10]	Wolfe, F., Clauw, D.J., Fitzcharles, M.A., Goldenberg, D.L., Katz, R.S., Mease, P., Russell, A.S., Russell, I.J., Winfield, J.B. and Yunus, M.B. (2010) The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research (Hoboken), 62, 600-610. http://onlinelibrary.wiley.com/doi/10.1002/acr.20140/full http://dx.doi.org/10.1002/acr.20140
[11]	Yokota, S., Kikuchi, M. and Miyamae, T. (2013) Juvenile Fibromyalgia: Guidance for Management. Pediatrics International, 55, 403-409. http://onlinelibrary.wiley.com/doi/10.1111/ped.12155/full http://dx.doi.org/10.1111/ped.12155
[12]	Schanberg, L.E., Anthony, K.K., Gil, K.M., Lefebvre, J.C., Kredich, D.W. and Macharoni, L.M. (2001) Family Pain History Predicts Child Health Status in Children with Chronic Rheumatic Disease. Pediatrics, 108, E47. http://pediatrics.aappublications.org/content/108/3/e47.long http://dx.doi.org/10.1542/peds.108.3.e47
[13]	Kashikar-Zuck, S., Lynch, A.M., Slater, S., Graham, T.B., Swain, N.F. and Noll, R.B. (2008) Family Factors, Emotional Functioning, and Functional Impairment in Juvenile Fibromyalgia Syndrome. Arthritis & Rheumatology, 59, 1392-1398. http://onlinelibrary.wiley.com/doi/10.1002/art.24099/full http://dx.doi.org/10.1002/art.24099
[14]	Miyamae, T., Watanabe, Y. and Yokota, S. (2008) The Actual State and Clinical Features of Fibromyalgia in Our Country. The Journal of the Japan Pediatric Society, 112, 1769-1777.
[15]	Yokota, S., Umebayashi, H., Miyamae, T., Imagawa, T. and Mori, M. (2007) Our Experience of 3 Cases with Childhood Fibromyalgia. The Journal of the Japan Pediatric Society, 111, 462-468.