Chronic fatigue syndrome

Sometimes called chronic Epstein-Barr virus, or myalgic encephalomyelitis, chronic fatigue and immune dysfunction syndrome is typically marked by debilitating fatigue, neurologic abnormalities, and persistent symptoms that suggest chronic mononucleosis. It commonly occurs in adults younger than age 45, primarily in females.

Causes

The cause of chronic fatigue syndrome (CFS) is unknown, but researchers suspect that it may be found in human herpes virus-6 or in other herpesviruses, enteroviruses, or retroviruses. Recent studies have shown that inflammation of nervous system pathways, acting as an immune or autoimmune response, may play a role as well. CFS may also be associated with a reaction to viral illness that’s complicated by dysfunctional immune response and by other factors that may include gender, age, genetic disposition, prior illness, stress, and environment.

Signs and symptoms

CFS has specific symptoms and signs, based on the exclusion of other possible causes. Its characteristic symptom is prolonged, often overwhelming fatigue that’s commonly associated with a varying complex of other symptoms that are similar to those of many infections, including myalgia and cephalgia. It may develop within a few hours and can last for 6 months or more. Fatigue isn’t relieved by rest and is severe enough to restrict activities of daily living by at least 50%. To aid in disease identification, the Centers for Disease Control and Prevention (CDC) uses a “working case definition” to group symptoms and severity.

Diagnosis

Because the cause and nature of CFS are still unknown, no single test unequivocally confirms its presence. Therefore, physicians base this diagnosis on the patient’s history and the CDC’s criteria. (See CDC criteria for diagnosing chronic fatigue syndrome.) Because the CDC criteria are admittedly a working concept that may not include all forms of this disease and are based on symptoms that can result from other diseases, diagnosis is difficult and uncertain.

Treatment

No treatment is known to cure CFS. Symptomatic treatment may involve the use of medications to treat depression, anxiety, pain, discomfort, and fever. Hidden yeast infections may be present and should be treated. Antiviral drugs such as acyclovir and selected immunomodulating agents, such as I.V. gamma globulin, ampligen, and transfer factor, may be of assistance.

Special considerations

❑ Some patients may benefit from avoiding environmental irritants and certain foods.

❑ Because patients with CFS may benefit from supportive contact with others who share this disease, refer the patient to the CFS Association for information and to local support groups. Patients may also benefit from psychological counseling.

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Book Source Details

• Book Title: Professional Guide to Diseases (Eighth Edition)
• Author(s): Springhouse
• Year of Publication: 2005
• Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.

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Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2008 Williams & Wilkins.

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More About This Book: Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X

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