Significance of inflammatory markers in primary Fibromyalgia syndrome and their relation in assessing the disease severity

Egypt J Immunol. 2024 Jan;31(1):67-74.


Fibromyalgia syndrome (FMS) is a musculoskeletal disorder characterized by diffuse chronic musculoskeletal pain associated with various other symptoms. Although the etiology and pathogenesis of FMS are still unclear, it was reported to have a possible inflammatory basis. No laboratory marker is currently available to diagnose the disease. This study aimed to search for biomarkers useful in diagnosis of FMS. We assessed blood erythrocyte sedimentation rate (ESR), neutrophil lymphocyte ratio (NLR), the mean platelet volume (MPV) and platelet distribution width (PDW), and serum levels of C-reactive protein (CRP), as inflammatory markers in primary FMS patients and their relationship with disease severity and depression scores. The study included 30 FMS patients, diagnosed according to the 2010 ACR (American Colleague of Rheumatology) criteria and 30 normal volunteers as a control group. FMS patients filled out the Revised Fibromyalgia Impact Questionnaire (FIQR) and Montgomery Asberg Depression Score (MADRS) as well. There was a significant difference in the studied parameters including ESR, CRP, NLR, MPV between study patients and control groups (p <0.05 for all). However, PDW did not differ between the two study groups. Based on our study findings, we can conclude that serum levels of the tested inflammatory markers including ESR, CRP, NLR, and MPV were higher in patients than in controls which makes them of good diagnostic value in patients with fibromyalgia. Meanwhile, some of these markers, mainly the acute phase reactants, have a positive relation with disease severity and depression scores, which in turn affect the quality of daily living.

MeSH terms

  • Biomarkers
  • C-Reactive Protein / analysis
  • Fibromyalgia* / diagnosis
  • Humans
  • Mean Platelet Volume
  • Patient Acuity


  • Biomarkers
  • C-Reactive Protein