In a recent study published by Injean et al in ACR Open Rheumatology, investigators assessed whether some patients who have been diagnosed with fibromyalgia may also have hypophosphatasia. Hypophosphatasia—characterized by ALP mutations and incomplete or defective bone mineralization—may present as a syndrome similar to fibromyalgia. In the retrospective study, the investigators evaluated 611 patients who had been diagnosed with fibromyalgia and had either low or normal alkaline phosphatase levels. The investigators found that 33% (n = 200) of patients had at least one low measurement of alkaline phosphatase and 9% (n = 57) of them had at least three successively low measurements of the enzyme—44% (n =25) of whom had a history of fractures. Additionally, none of the patients had undergone testing for vitamin B6 levels, zinc or magnesium levels, or hypophosphatasia. The investigators concluded that because enzyme replacement therapy can help prevent complications such as fractures in this patient population, it may be critical to screen for hypophosphatasia as part of the diagnostic procedure for fibromyalgia.
September 14, 2023