The 1988 chronic fatigue syndrome (CFS) working case definition (Holmes, et al) did not effectively distinguish CFS from other types of unexplained fatigue. For this reason, it was decided during a 1993 meeting of CFS investigators to develop a logical revision of that definition. The core of the revised CFS case definition is a set of uniformly applicable guidelines for the clinical and research evaluation of CFS and the other forms of fatigue.
The Revised Case Definition (abridged version)
In the revised definition, a consensus viewpoint from many of the leading CFS researchers and clinicians (including input from patient group representatives), chronic fatigue syndrome is treated as a subset of chronic fatigue, a broader category defined as unexplained fatigue of greater than or equal to six month's duration. Chronic fatigue in turn, is treated as a subset of prolonged fatigue, which is defined as fatigue lasting one or more months. The expectation is that scientists will devise epidemiologic studies of populations with prolonged fatigue and chronic fatigue, and search within those populations for illness patterns consistent with CFS.
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1: Clin Exp Rheumatol. 2006 Mar-Apr;24(2):179-82.
A first study of cytokine genomic polymorphisms in CFS: Positive association of TNF-857 and IFNgamma 874 rare alleles.
Immunogenetics Laboratory, Dept. of Genetics and Microbiology, University of Pavia, Italy. nickics@ipvgen.unipv.itOBJECTIVE: In the past two years we have developed a biological bank of genomic DNA, cDNA, serum and red blood cells of Italian patients with certified CFS from the two Italian referral centers for the syndrome. Recent studies have shown an imbalance in cytokine production in disease states similar to Chronic Fatigue Syndrome (CFS), such as sickness behavior, both in animals and in humans. However we notice that serum cytokine concentrations are often inconstant and degrade rapidly. With this in mind, we investigated cytokine gene polymorphisms in 80 Italian patients with CFS in order to ascertain whether in this group of patients it is possible to describe a genetic predisposition to an inflammatory response. METHODS: We analyzed the promoter polymorphisms of IL-10, IL-6 and the IFNgamma 874 T/A polymorphism in intron 1 with a PCR-SSP method (Cytogen One Lambda Inc. Canoga Park, CA, U.S.A) in 54 patients and TNF-308 G/A and -857 C/T promoter polymorphisms with a PCR-RFLP method (in 54 and 80 patients respectively). RESULTS: There is a highly significant increase of TNF -857 TT and CT genotypes (p = 0.002) among patients with respect to controls and a significant decrease of IFN gamma low producers (A/A) (p = 0.04) among patients with respect to controls. CONCLUSIONS: We hypothesize that CFS patients can have a genetic predisposition to an immunomodulatory response of an inflammatory nature probably secondary to one or more environmental insults of unknown nature.PMID: 16762155 [PubMed - indexed for MEDLINE]- --------------------------------------------------------------------------
1: Nippon Rinsho. 2007 Jun;65(6):1121-33.[School phobia and childhood chronic fatigue syndrome (CCFS)]
[Article in Japanese]Department of Child Developmental Sociology, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University.Chronic fatigue occurring in previously healthy children and adolescents is a vexing problem encountered by pediatric practitioners and the impact of fatigue in youngsters should not be underestimated. In its severe form, it is often associated with mood disorders. Findings in children and adolescent cases suggest that severe unexplained fatigue might precede the development of fatigue-related illness, such as childhood chronic fatigue syndrome (CCFS). This is a disabling condition characterized by severe disabling fatigue and a combination of symptoms, the prominent features being self-reported impairments in concentration and short-term memory, sleep disturbances and autonomic symptoms that cannot be explained by medical or psychiatric illness. We have encountered such patients with these complaints; their major symptoms include: general fatigue, fever, headache (not migraine), and memory disturbance. From our clinical experience, we have inferred that patients with CCFS might experience changes in brain function levels, which induce an autonomic imbalance and engender symptoms such as general fatigue, higher-order level cognitive dysfunction, and memory disturbance.PMID: 17561707 [PubMed - indexed for MEDLINE]
---------------------------------------------------------------------------------Chronic fatigue syndrome researchers offer physical evidence
Main Category: Depression
Article Date: 24 Aug 2004 - 0:00 PST
A University of Alberta study has verified that there is physical evidence for those who suffer from chronic fatigue syndrome (CFS), giving new weight to the often stigmatized and misdiagnosed disorder. Research just published in the "International Journal of Psychophysiology" determined that, using independent criteria, CFS can be distinguished from depression--two disorders that share many of the same symptoms.
CFS is an often debilitating disorder, characterized by a constellation of symptoms including fever, sore throat, headache, muscle weakness, myalgias, post-external malaise, sleep and cognitive disturbances. The level of disability varies for people with CFS, but some individuals find they are unable to return to work or function normally on a day-to-day basis. Unfortunately, many of these symptoms are subjective in nature and are difficult to quantify or confirm, says Hannah Pazderka-Robinson, the lead author on the study. Not only does the stigma attached with the disorder play an emotional toll on the patient, but it has implications for insurance claims as well.
"There are a number of medical professionals who don't believe that CFS exists in the first place," said Pazderka-Robinson. "The problem is, both CFS and depression are characterized by very similar profiles. Imagine a patient who approaches a doctor and tells him they feel depressed and tired all the time.
"Since depression shows a high co-morbidity with CFS, some CFS patients are often given antidepressants--that don't work or work poorly, since they do not address the underlying condition. Again, when these medications don't work, physicians sometimes jump to the conclusion that there isn't really anything, physically, wrong. Obviously, both misdiagnosis and the tendency for doctors to treat these patients as if they're not really sick can be extremely distressing. It can also undermine the patient's trust in the doctor and make them less likely to seek treatment if the condition worsens."
Article here
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Evidence for Chronic Fatigue Syndrome?
Proteins in Spinal Fluid May Be Markers of Syndrome, Early Tests ShowDec. 1, 2005 -- Scientists may have found biological evidence of chronic fatigue syndrome.
Chronic fatigue syndrome involves severe, unexplained tiredness that lasts for at least six months and doesn't improve with rest.
Chronic fatigue syndrome often greatly interferes with patients' lives. But it hasn't been well understood from a scientific point of view, and its cause is unknown.
The new evidence lies in patients' spinal fluid. Tests show 16 proteins in the spinal fluid of people with chronic fatigue syndrome but not in healthy people, according to a study in BMC Neurology.
link
Chronic fatigue syndrome may be a legitimate neurological condition
Researchers might have found evidence that chronic fatigue syndrome is a real and legitimate neurological condition.
A pilot study published in the open access journal BMC Neurology reveals that patients with chronic fatigue syndrome (CFS) have a set of proteins in their spinal cord fluid that were not detected in healthy individuals. These proteins might give insight into the causes of CFS, and could be used as markers to diagnose patients with CFS.
1 comment:
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