mrjСовременная ревматологияModern Rheumatology Journal1996-70122310-158XIMA-PRESS, LLC10.14412/1996-7012-2024-3-99-106mrj-1595Research ArticleОБЗОРЫREVIEWSВторичная фибромиалгия у детей с иммуновоспалительными ревматическими заболеваниямиSecondary fibromyalgia in children with immune-inflammatory rheumatic diseaseshttps://orcid.org/0000-0003-4750-5623СантимовА. В.SantimovA. V.

Андрей Вячеславович Сантимов

194100; ул. Литовская, 2; Санкт-Петербург

Andrey Vyacheslavovich Santimov

194100; 2, Litovskaya Street; St. Petersburg

a.santimoff@gmail.comhttps://orcid.org/0000-0001-5967-4315ГречаныйС. В.GrechanyiS. V.

194100; ул. Литовская, 2; Санкт-Петербург

194100; 2, Litovskaya Street; St. Petersburg

https://orcid.org/0000-0002-7571-5460НовикГ. А.NovikG. A.

194100; ул. Литовская, 2; Санкт-Петербург

194100; 2, Litovskaya Street; St. Petersburg

ФГБОУ ВО «Санкт-Петербургский государственный педиатрический медицинский университет» Минздрава РоссииРоссияSt. Petersburg State Pediatric Medical University, Ministry of Health of RussiaRussian Federation20241506202418399106Copyright © Сантимов А.В., Гречаный С.В., Новик Г.А., 20242024Сантимов А.В., Гречаный С.В., Новик Г.А.Santimov A.V., Grechanyi S.V., Novik G.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mrj.ima-press.net/mrj/article/view/1595

   У пациентов, страдающих иммуновоспалительными ревматическими заболеваниями (ИВРЗ), отмечается высокая распространенность невоспалительной мышечно-скелетной боли, связанной с дисфункцией ноцицептивной системы, центральной сенситизацией и вторичной фибромиалгией (ФМ). В последние годы появляется все больше публикаций, посвященных ФМ при ревматоидном артрите и системных  заболеваниях соединительной ткани у взрослых пациентов, тогда как в педиатрической ревматологии эта проблема мало обсуждается, в том числе в связи с различиями в существующих диагностических критериях у детей и взрослых, затрудняющими диагностику ювенильной вторичной ФМ. Следствием этого зачастую является необоснованное назначение или замена базисных или генно-инженерных биологических препаратов у пациентов, которые нуждаются не в усилении противоревматической терапии, а в психотерапии и психофармакотерапии и более широком применении методов физической и реабилитационной медицины. В кратком описательном обзоре сделана попытка проследить в историческом аспекте изучение ФМ в ревматологической клинике, в том числе у детей с ИВРЗ, обобщить актуальные данные литературы, посвященные этой проблеме, и обозначить возможные пути ее решения.

   Patients with immune-inflammatory rheumatic diseases (IIRDs) often present with non-inflammatory musculoskeletal pain associated with nociceptive dysfunction, central sensitization, and secondary fibromyalgia (FM). In recent years, an increasing number of publications have appeared dealing with FM in rheumatoid arthritis and systemic connective tissue diseases in adult patients, while this problem is little discussed in pediatric rheumatology, partly due to the differences between the existing diagnostic criteria in children and adults, which complicate the diagnosis of juvenile secondary FM. The consequence of this is often the unfounded prescription or switching of synthetic disease-modifying antirheumatic drugs (DMARDs) or biologic DMARDs in patients who do not require intensified antirheumatic therapy, but rather psychotherapy and psychopharmacotherapy, as well as the wider use of physical and rehabilitation medicine methods. In a brief narrative review, we tried to trace the investigation of FM in a rheumatological clinic, including children with IIRD, from a historical perspective, to summarize current literature data on this problem and to point out possible solutions.

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The authors declare that there are no conflicts of interest present.