Elevated CSF levels of substance P and high incidence of Raynaud phenomenon in patients with fibromyalgia: new features for diagnosis

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Abstract
Tients revealed that 53.3% had Raynaud/Raynaud-like phenomenon localized in the fingers, the toes or both. Although SP levels did not differ significantly in patients with or without the Raynaud phenomenon, elevated activity may be present in the peripheral branches of SP neurons which could be responsible for the last (rubor) phase of the triphasic Raynaud's phenomenon. SP levels were significantly higher in patients who were smokers (40.1 ± 2.7 fmol/ml, range 25.3–64.1 fmol/ml), compared to patients who were non-smokers (29.2 ± 5.0 fmol/ml, range 16.5–79.1 fmol/ml). We propose elevated CSF levels of SP and the Raynaud phenomenon as characteristic features for fibromyalgia with potential as diagnostic markers of the disease and further that smoking might be an aggravating factor for its pathogenesis or development. Correspondence to: Dr. Henning Vaerøy, Oslo Sanitetsforenings Rheumatism Hospital, Akersbakken 27, 0172 Oslo 1, Norway. (Received 13 April 1987; revised received 3 July 1987; accepted 9 July 1987.( © Lippincott-Raven Publishers....