by John Gever: Complete Post through this link…
Study suggests 10% of cases may have easily treatable cause.
A substantial minority of patients diagnosed with fibromyalgia at one medical center in Southern California had “consistently low” levels of alkaline phosphatase (ALP), researchers said, which could have accounted for their symptoms.
Among 611 presumed cases of fibromyalgia, 57 (9.3%) had three or more consecutive ALP measurements below the reference range’s lower limit of 37 U/L, according to Christina Downey, MD, of Loma Linda University in California, and colleagues.
None of the 57 had undergone genomic analysis or other testing for hypophosphatasia (HPP), the clinical syndrome caused by ALP deficiency, suggesting that it had escaped clinicians’ notice at the time, the researchers reported in ACR Open Rheumatologyopens in a new tab or window. But many of them probably did have the condition, as 25 had a history of fractures despite a relatively young age (averaging 52 years old).
What makes the finding of probable HPP important is that, besides decreased bone density, its symptoms include chronic muscle and joint pain like that seen in fibromyalgia. Moreover, ALP levels can be normalized easily with asfotase alfa (Strensiq), an enzyme replacement therapy.
“The availability of medical treatment for HPP is perhaps the most pressing reason to identify these patients correctly,” Downey and colleagues wrote. “Due to the potential clinical consequences that stem from the misdiagnosis of HPP, we urge clinicians to consistently screen for HPP.”