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ción del eje hipotálamo-hipofisario. 2. Que hay casos de rinitis
alérgica estacional o no alérgica que se asocian a fibromial-
gia112. Precisamente el estudio de Cleveland y cols. 112 demos-
tró que la prevalencia de la fibromialgia en pacientes con rini-
tis era muy superior a la esperada en la población general ya
que mientras en ésta es del 4-5%, en los casos de rinitis estu-
diados demostraron que el 38% presentaban historia de
dolor difuso además de 11 o más puntos dolorosos que es
uno de los criterios que el American College of Reumatho-
logy institucionalizó en 1990 como hecho necesario para el
diagnóstico de fibromialgia. Y aún hay algo más, Bellanti y
cols.113 en 2005 insistieron en el papel de la alergia, especial-
mente a alimentos o sus componentes, como disparadores
del cuadro fisiopatológico del síndrome de la fatiga crónica y
de la fibromialgia. Todo esto habrá que comprobarlo en un
futuro inmediato.
Lo que sí está claro, y así lo hemos señalados desde el prin-
cipio, es que la histamina produce contracción del músculo
liso (fig. 1) y que, como síntoma directo sobre el sistema
musculoesquelético, podríamos comprobar calambres mus-
culares; sin embargo, hoy se piensa, y en ello se está investi-
gando, que habría una manifestaciones o síntomas indirectos
como dolor por presión y deshidratación de los discos inter-
vertebrales que acercarían la fibromialgia a la histaminosis109.
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Monografías de Dermatología 36