Category: Overlapping Illnesses

Fatigue syndromes: new thoughts and reinterpretation of previous data

Abstract:

Recently, the author has identified 19 patients who have complained of marked fatigue that had abnormal responses to copper test bracelets or necklaces. At this time, 8 have been shown to have at least one enzyme deficiency in the heme pathway. These patients have been diagnosed with multiple sclerosis, chronic fatigue syndrome and other non-specific diagnoses. A lengthy but still limited review of the literature was performed regarding the following conditions: multiple sclerosis (MS), hepatic porphyria (HP), chronic fatigue syndrome (CFS) and paralytic polio (PP). The text will focus on similar epidemiologies, laboratory findings and clinical courses. Copper as a common but not unique etiologic agent will be discussed; as will the heme pathway, a biologic process that may be disordered in all.

 

Source: Downey DC. Fatigue syndromes: new thoughts and reinterpretation of previous data. Med Hypotheses. 1992 Oct;39(2):185-90. http://www.ncbi.nlm.nih.gov/pubmed/1461185

 

Rheumatic fever and disorders of the musculoskeletal system

Abstract:

New information provided on the pathogenesis and management of rheumatic fever is of current interest. Invasive disease by group A streptococci has been shown to be due to production of toxin A. The natural history and immunopathologic basis for chronic Lyme arthritis are reported. Attention is drawn to pyomyositis and clinical presentation of chronic fatigue syndrome in children. Patients with Sweet’s syndrome often have antineutrophil cytoplasmic autoantibodies. Biopsy specimens of panniculitis should be taken to aid treatment. Long-term outcome in chronic osteomyelitis is favorable; recommendations on the rational use of imaging have been reported.

 

Source: Coovadia HM. Rheumatic fever and disorders of the musculoskeletal system. Curr Opin Rheumatol. 1992 Oct;4(5):718-24. http://www.ncbi.nlm.nih.gov/pubmed/1419508

 

Fibromyalgia, chronic fatigue, and myofascial pain syndromes

Abstract:

During the past year many studies have been published on fibromyalgia and chronic fatigue syndromes. Randomized clinical trials using current operational diagnostic criteria were reported, but no single therapy has been highly effective in either condition. The working case definition of chronic fatigue syndrome has been criticized and suggestions for a new case definition have been made. Further understanding of the overlap of these three common disorders will also require that uniform diagnostic criteria be tested in chronic fatigue syndrome and myofascial pain syndrome.

 

Source: Goldenberg DL. Fibromyalgia, chronic fatigue, and myofascial pain syndromes. Curr Opin Rheumatol. 1992 Apr;4(2):247-57. http://www.ncbi.nlm.nih.gov/pubmed/1581154

 

Seasonal affective disorder presenting as chronic fatigue syndrome

Abstract:

Although operational criteria have been recently proposed to better define chronic fatigue syndrome (CFS), it remains a controversial diagnosis. There are many overlapping symptoms between CFS and major depression. The author presents two patients with seasonal affective disorder, who responded to phototherapy and had previously been diagnosed as CFS. Because of the consequences of treatment, seasonal and non seasonal depression need to be ruled out in patients with chronic fatigue symptoms.

 

Source: Lam RW. Seasonal affective disorder presenting as chronic fatigue syndrome. Can J Psychiatry. 1991 Nov;36(9):680-2. http://www.ncbi.nlm.nih.gov/pubmed/1773405

 

Sleep and symptoms in fibrositis syndrome after a febrile illness

Abstract:

Sleep physiology and symptoms of 9 patients with fibrositis syndrome secondary to a febrile illness were compared to 9 patients with fibrositis syndrome who did not attribute their symptoms to a febrile illness and to 10 healthy controls.

Both patient groups showed an alpha EEG (7.5 to 11 Hz) nonrapid eye movement sleep anomaly, had similar observed tender points, and self-ratings of musculoskeletal pain.

These findings suggest that patients with postfebrile fibrositis have a nonrestorative sleep disorder characteristic of patients with fibrositis syndrome and share similar symptoms with patients who have a “chronic fatigue syndrome.”

 

Source: Moldofsky H, Saskin P, Lue FA. Sleep and symptoms in fibrositis syndrome after a febrile illness. J Rheumatol. 1988 Nov;15(11):1701-4. http://www.ncbi.nlm.nih.gov/pubmed/3236304

 

“Chronic Epstein-Barr virus infection” syndrome and polymyalgia rheumatica

Abstract:

Twenty-three patients with polymyalgia rheumatica (PMR) followed in an academic rheumatology practice frequently reported symptoms commonly found in the recently described “chronic fatigue syndrome” or “chronic Epstein-Barr infection syndrome.” These symptoms persisted for months after treatment had reduced the severity of the myalgias and lowered the sedimentation rate: periodically disabling fatigue (33%), recurrent pharyngitis (30%), sleep disorder (65%) and arthralgias (70%). However, antibody titers to Epstein-Barr virus in the patients with PMR were not significantly different from those in age and sex matched control subjects.

 

Source: Buchwald D, Sullivan JL, Leddy S, Komaroff AL. “Chronic Epstein-Barr virus infection” syndrome and polymyalgia rheumatica. J Rheumatol. 1988 Mar;15(3):479-82. http://www.ncbi.nlm.nih.gov/pubmed/2837573