Fibromyalgia (suspected)
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Initial tests
Laboratory tests
- FBC
- CRP
- TSH
- Creatine kinase (CK)
- Transaminases (AST, ALT)
Do not order
- Antinuclear antibodies, rheumatoid factor, anti-CCP with no clinical pointer: absent from the HAS minimum tests and from all the foreign guidelines it compared; other tests are prescribed according to the signs found [1,2].
- 25-hydroxyvitamin D: the HAS sees no value in it in fibromyalgia outside deficiencies linked to an identified disease [1], and this test falls outside the NABM indications (procedure 1139: “outside these situations, there is no point in measuring vitamin D”) [5].
- ESR, GGT, serum calcium, plasma glucose, electrolytes: proposed by some foreign guidelines “without justification of their indications”, not retained by the HAS [2]; ESR is no longer in the NABM [5].
Sources (5)
- Haute Autorité de santé. Fibromyalgie de l'adulte : conduite diagnostique et stratégie thérapeutique. Recommandation de bonne pratique, texte des recommandations. Validée par le Collège le 19 juin 2025, mise en ligne le 10 juillet 2025.
- Haute Autorité de santé. Fibromyalgie de l'adulte : conduite diagnostique et stratégie thérapeutique. Argumentaire scientifique, juin 2025 (chapitre 1.4, tableaux 7 et 8).
- Winslow BT, Vandal C, Dang L. Fibromyalgia: Diagnosis and Management. Am Fam Physician. 2023;107(2):137-144.
- National Institute for Health and Care Excellence. Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain. NICE guideline NG193, 7 avril 2021 (recommandations 1.1 et page « Context »).
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 : acte 1139 (25-OH-vitamine D) ; absence d'acte pour la VS.