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Vefjagigt í börnum og ungmennum : yfirlitsgrein

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Authors
Sigrún Baldursdóttir
Issue Date
2008-06-01

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Other Titles
Juvenile primary fibromyalgia syndrome--review
Citation
Læknablaðið 2008, 94(6):463-72
Abstract
Fibromyalgia syndrome is known to cause significant morbidity among adults characterised by widespread musculoskeletal pain, stiffness, fatigue, non-restorative sleep, cognitive dysfunction and diminished physical function. Although well-recognised in adults, the impact of the syndrome in the paediatric population has only recently been addressed. The estimated prevalence of juvenile primary fibromyalgia syndrome (JPFS) is 1.2%-6.2%. Prevalence is higher in girls than boys, and peaks at the time of puberty. JPFS is of unknown aetiology, characterised by numerous symptoms that mimic the symptoms of adult fibromyalgia syndrome, the most prevalent being sleep disturbance, widespread persistent musculoskeletal pain and fatigue. JPFS has a major influence on health, physical function and quality of life. The diagnosis of JPFS is based on the criteria defined by Yunus and Masi (1985), which include generalised musculoskeletal aching at three or more regions for at least three months and at least five of eighteen typical tender points. The precise cause of JPFS is unknown, but there is an emerging understanding that the development of this syndrome is related to many factors, such as genetic and anatomic factors, disordered sleep and psychological distress. According to emerging studies, a multidisciplinary treatment may be helpful in treating JPFS. Multicomponent treatment that includes attendance by patient and parents, sleep hygiene with or without medication, physical training and cognitive behavioural therapy, is advocated.
Vefjagigt er algengt verkjaheilkenni sem er best þekkt hjá fullorðnum og er fjórum sinnum algengara hjá konum en körlum. Helstu einkenni eru útbreiddir stoðkerfisverkir, svefntruflanir, óeðlileg þreyta og skert færni til daglegra athafna. Á síðustu árum hafa menn áttað sig á að vefjagigt finnst einnig hjá börnum og ungmennum og eru einkennin fjölþætt og svipar til einkenna vefjagigtar fullorðinna. Samkvæmt rannsóknum er vefjagigt til staðar hjá 1,2-6,2% barna á grunn-skólaaldri og líkt og hjá fullorðnum er heilkennið algengara hjá stúlkum en drengjum. Vefjagigt hefur umtalsverð áhrif á heilsu, daglega færni og lífsgæði barna og ungmenna. Greining vefjagigtar hjá börnum og ungmenn-um byggir á tveimur skilmerkjum: Útbreiddum stoðkerfisverkjum frá þremur líkamssvæðum í minnst þrjá mánuði og jákvæðum kvikupunktum á 5 af 18 stöðum. Orsakir vefjagigtar eru ekki þekktar en líklegt er talið að erfðir eigi þar einhvern þátt. Margir þættir eru taldir geta komið sjúkdómsferlinu af stað, meðal annars svefntruflanir, sálfélagslegir þættir, ofhreyfanleiki og aðrir undirliggjandi sjúkdómar. Rannsóknarniðurstöður sem liggja fyrir benda til að draga megi úr einkennum vefjagigtar með viðeigandi meðferð. Meðferð sem felst í fræðslu, þátttöku sjúklings og foreldra hans, bættu svefn-mynstri með eða án lyfjagjafar, líkamsþjálfun og hugrænni atferlismeðferð hefur gefið góðan árangur
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