Evidence for similarity in symptoms and mechanism: The extra-pulmonary symptoms of severe asthma and the presentation of fibromyalgia (And ME/CFS).

Immun Inflamm Dis. 2019 Aug 23. doi: 10.1002/iid3.263. [Epub ahead of print]
Evidence for similarity in symptoms and mechanism: The extra-pulmonary symptoms of severe asthma and the polysymptomatic presentation of fibromyalgia.
Hyland ME1,2, Lanario JW1,2, Wei Y3, Jones RC4, Masoli M2.
Author information
1School of Psychology, University of Plymouth of Plymouth, Plymouth, UK.2University Hospitals Plymouth NHS Trust, Plymouth, UK.3School of Computing, Electronics and Mathematics, University of Plymouth, Plymouth, UK.4Department of Respiratory Medicine, Peninsula School of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
Asthma is a disease of the lung and a systemic disease. Functional disorders are associated with multiple systemic abnormalities that have been explained by complexity models. The aim was to test the similarity in type and aetiology between the extra-pulmonary symptoms of severe asthma and the symptoms of fibromyalgia.
One Hundred patients recruited from a specialist severe asthma clinic and 1751 people reporting different functional disorder diagnoses recruited via the internet completed the same 60-item questionnaire. Symptom patterns were compared between groups using a new measure, the symptom pattern similarity index where 0 = no relationship, 1 = identical patterns between groups.

Severe asthma patients report numerous extra-pulmonary symptoms. The similarity index between the symptom pattern of the asthma patients with other groups was irritable bowel syndrome = 0.54, chronic fatigue syndrome = 0.69, and fibromyalgia = 0.75. The index between fibromyalgia and asthma patients with the most and least frequent extra-pulmonary symptoms was 0.81 and 0.55 respectively.

Patients with severe asthma have numerous extra-pulmonary symptoms similar in type and pattern to the symptoms of fibromyalgia. The similarity of the symptom pattern between asthma and fibromyalgia increases as the number of extra-pulmonary symptoms increases as predicted by network theory and previously shown to be the case with other functional disorders. These findings support the hypothesis that functional disorders and extra-pulmonary asthma symptoms have a common complexity or network aetiology. Evidence based behavioural interventions for fibromyalgia may be helpful for patients with severe asthma reporting extra-pulmonary symptoms.
© 2019 The Authors. Immunity, Inflammation and Disease Published by John Wiley & Sons Ltd.
Severe asthma; biopsychosocial interaction; complexity; fibromyalgia; functional disorder; network
PMID: 31441602 DOI: 10.1002/iid3.263