Fibromyalgia, Chronic Fatigue, Functional Disorders, and Vaccination: Where Do We Stand?

Fibromyalgia syndrome (FMS) represents a unique entity within the field of rheumatology, differing from the more "classical" rheumatological disorders both in pathogenesis and in its modes of management. Gulf War syndrome (GWS) is an unusual case of a functional disorder strictly situated in a specific historical and geographical circumstance. Characterized by chronic fatigue, musculoskeletal symptoms, malaise, and cognitive impairment, GWS clinically overlaps with both post-traumatic stress disorders (PTSD) and FMS/chronic fatigue syndrome (CFS), as well as with other functional disorders. FMS and CFS are conditions with considerable clinical overlap. Fatigue is an inherent symptom of FMS, along with disturbed nonrefreshing sleep, while muscular pain is a common symptom among those diagnosed as suffering from CFS. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a recently described entity that encompasses symptoms from a number of clinical syndromes, including siliconosis, GWS, macrophagic myofasciitis (MMF), and post-vaccination phenomena linked with exposure to an adjuvant.