Tag: allergy

A case of chronic fatigue syndrome who showed a beneficial effect by intravenous administration of magnesium sulphate

Abstract:

We have treated a case of chronic fatigue syndrome with atopic diathesis was had suffered general malaise, low grade fever, swelling of the lymph nodes, myalgias and arthralgias for a long time.

A 29-year-old female, who had been treated for atopic dermatitis for 5 years, complained of general malaise in May 1990. She was admitted to the nearest hospital in December 1990 because of low grade fever, swelling of the lymph nodes and an elevation of antinuclear antibody (2520x). She was transferred to our hospital in May 1991.

A diagnosis of collagen disease was not compatible with her condition. In addition to general malaise, fever and lymph node swelling, headache, myalgias, muscle weakness, arthralgias and insomnia were observed, and a diagnosis of chronic fatigue syndrome was made based on the working case definition proposed by Holmes et al.

Although eosinophilia, a high serum level of IgE, and elevation of RAST scores, low NK and ADCC activity, and a reduced level of NK cells in the peripheral blood were detected, serum antibodies to a number of viruses were in the normal range.

Treatments with non-steroid anti-inflammatory drugs, minor tranquilizers and antidepressant drugs were not effective at all. An administration of magnesium sulphate was intravenously performed once a week in order to improve her condition, especially severe general malaise. After about 6-week’s administration of magnesium sulphate, she noticed reduced easy fatigability and an improvement in her impaired daily activities. Finally she was able to leave the hospital in January 1992.(ABSTRACT TRUNCATED AT 250 WORDS)

 

Source: Takahashi H, Imai K, Katanuma A, Sugaya T, Hisano K, Motoya S, Aoki S, Sugiyama T, Yachi. A case of chronic fatigue syndrome who showed a beneficial effect by intravenous administration of magnesium sulphate. Arerugi. 1992 Nov;41(11):1605-10. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1492795

 

Chronic fatigue syndrome–cases in the Kanebo Memorial Hospital

Abstract:

In our hospital, 134 patients (28 male, 106 female, 10-82 years of age) were diagnosed as having chronic fatigue syndrome (CFS). Some patients had mild elevation of antibodies against Epstein-Barr Virus and immunologic abnormalities (natural killer cell dysfunction and high rates of skin reactivity to house dust, pollen, drugs and common food). In the patients with immunologic abnormalities, we found decreases in serum concentrations of arachidonic acid and dihomogamma-linolenic acid. A Kampo medicine, Ren-Shen-Yang-Rong-Tang was used in the management of 134 patients and 98 patients returned to work or school.

 

Source: Ogawa R, Toyama S, Matsumoto H. Chronic fatigue syndrome–cases in the Kanebo Memorial Hospital. Nihon Rinsho. 1992 Nov;50(11):2648-52. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1337561

 

Myalgic encephalomyelitis

Comment in: Myalgic encephalomyelitis. [J R Soc Med. 1991]

Comment on: Myalgic encephalomyelitis: an alternative theory. [J R Soc Med. 1990]

 

I am pleased that Dr Wilson (August 1990 JRSM, p481) has paid me the compliment of giving my article on the vexed topic of ‘myalgic encephalomyelitis’ (April 1989 JRSM, p 215) serious attention, and echoes our call’ for a ‘new approach’ to the problem, based on an absence of prejudice and a sound clinical and social history. He also notes the parallels between neurasthenia and ‘ME’, although the former was not, as he writes, first described in 18842. However, I only wish I could follow the rest of his arguments so clearly:

Dr Wilson states that I failed to realize that ‘about 100%’ of patients have an allergic diathesis and an allergic family history. I was indeed unaware of this remarkable finding. Unfortunately, I have been unable to trace the two sources cited for this observation, one an American paperback, the other a society newsletter. Similarly, I am afraid that neither I nor any of my colleagues have ever met anyone suffering from ‘Alternate Multiple Personality’. Perhaps this was because I was again unaware of the relevant literature. However, in my defence I would not otherwise have known that the two references quoted, namely Dr Wilson’s paper on allergic disease, multiple personality and dowsing, and his paper on possession and multiple personality, are actually about chronic fatigue syndrome. Similarly, I would not have known that an article in the Christian Parapsychologist called ‘Deliverance and dowsing’ is on the psychopathology of allergy and ME, nor that information on treatment of ME would be published in a series of titles beginning with ‘Current theological perspectives on possession. It is becoming harder to keep up with the relevant literature.

You can read the rest of this comment here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1293160/pdf/jrsocmed00126-0074c.pdf

 

See the article “Myalgic encephalomyelitis: an alternative theory.” in volume 83 on page 481.

See letter “Myalgic encephalomyelitis.” on page 633.

See the reply “The author replies” on page 183a.

 

Source: Wessely S. Myalgic encephalomyelitis. J R Soc Med. 1991 Mar;84(3):182-3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1293160/

 

Myalgic encephalomyelitis: an alternative theory

Note: in this editorial published in the Journal of the Royal Society of Medicine ,Volume 83, August 1990, Dr. Wilson discusses the role allergy plays in the development of post-viral fatigue syndromes.

 

In his discussion paper on myalgic encephalomyelitis (April 1989 JRSM, p 215), Wessley drew attention to the destruction of body and mind, and subsequent suicidal despair, and torment, of patients suffering from myalgic encephalomyelitis (ME) or the postviral fatigue syndrome (PVFS). He referred to the reported relationship between identification of the VPI antigen and the presence of disease symptoms. He stated that more attention requires to be paid to methodological detail which he defined as population sample definition, and adoption of operational criteria. He suggested that a new term should be used to describe the observed symptoms: chronic fatigue syndrome (CFS), and enquired what constitutes the syndrome? Unfortunately he did not refer to the necessity for taking a complete clinical and family history in all patients. In his definition of CFS, he did not refer to any of the somatic symptoms which are always present. Yet, he stated that cases of this disease can only be selected by the (presumably holistic) clinical history. It appears that a new kind of approach based on absence of prejudice, more exhaustive and thorough clinical history taking, a wider approach to clinical examination of the patients, and a critical assessment of the origin of this psychosomatic disease would be of value in our investigations.

You can read the rest of the article here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292769/pdf/jrsocmed00133-0005b.pdf

 

Source: Wilson CW. Myalgic encephalomyelitis: an alternative theory. J R Soc Med. 1990 Aug;83(8):481-483. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292769/

 

Post-viral fatigue syndrome, viral infections in atopic eczema, and essential fatty acids

Abstract:

Three clinical observations relating to viral infections are well-known but poorly understood. These are: the susceptibility of people with atopic eczema to viral infections; the occasional precipitation of an atopic syndrome by viral infections; the occurrence of a fatigue syndrome following viral infections.

A unifying hypothesis is presented which explains these observations in terms of the interactions between viral infections and essential fatty acid (EFA) metabolism. Key elements of the hypothesis are the facts that interferon requires 6-desaturated EFAs in order to exert its anti-viral effects, that people with atopic eczema have low levels of 6-desaturated EFAs, and that viruses, as part of their attack strategy, may reduce the ability of cells to make 6-desaturated EFAs.

The hypothesis has practical implications for the treatment of patients with viral infections.

 

Source: Horrobin DF. Post-viral fatigue syndrome, viral infections in atopic eczema, and essential fatty acids.  Med Hypotheses. 1990 Jul;32(3):211-7.  http://www.ncbi.nlm.nih.gov/pubmed/2204789

 

Chronic fatigue syndrome

Note: This letter was written in response to a letter published in the Canadian Medical Association Journal on May 1, 1989. You can read Holland’s letter here:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1268972/pdf/cmaj00190-0022b.pdf

 

It is regrettable that the publication of an earlier letter from one of us (G.H.R.) and Dr. Jean A. Monro (Can Med Assocj 1989; 140: 361) generated surprise (and apparent disapproval of CMAJ’s action) on the part of Dr. Ray Holland (ibid 1016).

In expressing his disagreement with the use of the term “chronic fatigue syndrome” Holland also appears to be at odds with the US Centers for Disease Control (CDC), whose case definition for this condition (1) was the main point of the earlier letter. We have no disagreement with Holland that “there are also primary psychologic causes of chronic fatigue”. However, the CDC case definition specifically calls for the exclusion of clinical conditions, including psychiatric disease, that may produce similar symptoms.

The whole issue of what triggers psychologic symptoms or illness, however, is an important related matter. Holland reports, quite rightly, that panic disorder appears to be increasingly common. As physicians we have been led to assume that panic disorder has a psychologic origin rather than identifiable extrinsic causes. At the Environmental Health Center – Dallas we have confirmed that panic attacks and other emotional responses may be reproducibly triggered by double-blind testing for sensitivities to foods, inhalants and chemicals. (2)

Similar behavioural effects have been seen in pesticide poisoning (3) and with exposure to other environmental toxins. (4) Specifically, panic attacks have been cited in the psychiatric literature as being triggered by solvent exposure. (5’6)

Being unable to find physical diagnoses for chronic fatigue does not necessarily mean that psychologic illness is the cause. It may simply be that our understanding of the factors precipitating the illness is far from complete. Medical history teaches us that once physical causes for “psychologic” symptoms are discovered the condition moves, as if by magic, from the psychiatric to the medical realm. A good example of this is the relief of behavioural symptoms by correction of thiamin (7) or cobalamin (8) deficiency.

It is our experience that a substantial percentage of chronic fatigue cases (not a minuscule percentage, as Holland suggests) may arise from or be worsened by adverse reactions to components of the patient’s total environment, such as food, inhalants and chemicals.

~Gerald H. Ross, MD, CCFP Fellow in environmental medicine

~William J. Rea, MD, FACS, FAAEM Medical director

~Alfred R. Johnson, DO, FAAEM Environmental Health Center – Dallas; Dallas, Texas

References

1. Holmes GP, Kaplan JE, Gantz NM et al: Chronic fatigue syndrome: a working case definition. Ann Intern Med 1988; 108: 387-389
2. King DS: Can allergic exposure provoke psychological symptoms? A double-blind test. Biol Psychiatry 1981; 16:3-19
3. Rea Wl, Butler JR, Laseter JL et al: Pesticides and brain function changes in a controlled environment. Clin Ecol 1984; 2:145-150
4. Fein GG, Schwartz PM, Jacobson SW et al: Environmental toxins and behavioral development: a new role for psychological research. Am Psychologist 1983; 38: 1188-1197
5. Dager SR, Holland JP, Cowley DS et al: Panic disorder precipitated by exposure to organic solvents in the work place. Am I Psychiatry 1987; 144:1056-1058
6. Lindstrom K, Ruhimake H, Hamminen K: Occupational solvent exposure and neuropsychiatric disorders. Scand J Work Environ Health 1984; 10: 321-323
7. McLaren DS: Clinical manifestations of nutritional disorders. In Shils ME, Young VR (eds): Modem Nutrition in Health and Disease, Lea and Febiger, Philadelphia, 1988: 733-745
8. Lindenbaum J, Healton EB, Savage DG, et al: Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N EnglJ Med 1988; 318: 1720-1729

 

Source: G H Ross, W J Rea, and A R Johnson. Chronic fatigue syndrome. CMAJ. 1989 Jul 1; 141(1): 11–12. PMCID: PMC1269261  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1269261/

 

Allergy and the chronic fatigue syndrome

Abstract:

The chronic fatigue syndrome is a heterogeneous disorder characterized by easy fatigability, feverishness, diffuse pains, and depression. Many patients also report inhalant, food, or drug allergies.

This article reviews the clinical features of the syndrome and hypotheses of its pathogenesis, especially those regarding the Epstein-Barr virus and cellular immune mechanisms. Also summarized are recent studies of the validity of atopic complaints in the syndrome.

The results of epicutaneous skin testing demonstrated a high correlation with history in 24 patients. Atopy coexists with the chronic fatigue syndrome in greater than 50% of patients.

 

Source: Straus SE, Dale JK, Wright R, Metcalfe DD. Allergy and the chronic fatigue syndrome. J Allergy Clin Immunol. 1988 May;81(5 Pt 1):791-5. http://www.ncbi.nlm.nih.gov/pubmed/2836490