Definition of the chronic fatigue syndrome and its issues

Abstract:

This article reviewed Definition of CFS proposed by CDC 1988. There are several issues in Definition for CFS of CDC. It is presented that other chronic clinical conditions have been satisfactorily excluded, including preexisting psychiatric diseases in (2) of major criteria.

However, fibromyalgia can not be excluded from the fifth symptom of minor criteria, myalgia, and also depression from the ninth symptom.

It is practically difficult to define impairment of average daily activity below 50% of the patient’s premorbid activity level for a period of at least 6 months, as shown in (1) of major criteria, and it is not adapted for a first visit patient.

Definition for CFS of CDC has been discussed on EBV infection, but not written on postviral fatigue syndrome and myalgic encephalomyelitis. Especially whether epidemic type of CFS is present or not was not discussed. Diagnostic criteria of CFS is necessary for clinical practice.

 

Source: Hashimoto N. Definition of the chronic fatigue syndrome and its issues. Nihon Rinsho. 1992 Nov;50(11):2591-9. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1287235

 

Chronic fatigue syndrome–symptoms, signs, laboratory tests, and prognosis

Abstract:

Chronic fatigue syndrome (CFS) is an undefined clinical problem and is perceived as a complex of multiple symptomatology with an unexplained persistent fatigue. Major symptoms include fatigue lasting for more than 6 months, low-grade fever, moderate lymphadenopathy, muscle and joint pain, and various psychological presentations. Since no specific laboratory tests are available, clinical diagnosis demands that known causes of chronic fatigue should be excluded. The pathogenesis is at present unknown, but it is suspected that CFS is a physical and psychological condition associated with some unrecognized infectious agent. Further study is needed to clarify the precise pathophysiology of this newly recognized entity.

 

Source: Kanayama Y. Chronic fatigue syndrome–symptoms, signs, laboratory tests, and prognosis. Nihon Rinsho. 1992 Nov;50(11):2586-90. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1287234

 

Chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS), which is characterized by devastating fatigue, mild fever, lymphadenopathy, headache, myalgia, insomnia and neuropsychiatric disorders, now has drawn much attentions from many physicians, researchers and even peoples in general society world wide. The pathogenesis of CFS is still remains to be clarified and clinico-pathological difference between CFS and mood disorder is controversial. In this paper, CFS would be reviewed in detail.

 

Source: Matsuda J. Chronic fatigue syndrome. Nihon Rinsho. 1992 Apr;50(4):887-91. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/1619775

 

Studies on the relationship between chronic fatigue syndrome and Epstein-Barr virus in Japan

Abstract:

Among 1,153 consecutive patients, 22 patients (1.9%) who complained of chronic fatigue for a period of over 6 months without detectable causes were studied.

Ten patients (0.86%) satisfied the criteria of chronic fatigue syndrome (CFS) and were classified to be definite cases of CFS. The other patients were classified as probable cases.

In order to clarify the role of Epstein-Barr virus (EBV) as a cause of CFS, we measured various antibodies for EBV. The definite cases had significantly higher titers of early antigen complex (EA)-IgG than both the probable cases and controls.

We proposed the EA-IgG/EBNA ratio as the indicator of activation of EBV and attempted to estimate the degree of fatigue by the EA-IgG/EBNA ratio. The highest ratio value (16.0) of the 22 patients ratios was the most serious case. In general, the ratio correlated with the degree of fatigue. Based on these results, it was concluded that a relationship does exist between CFS and EBV.

 

Source: Kawai K, Kawai A. Studies on the relationship between chronic fatigue syndrome and Epstein-Barr virus in Japan. Intern Med. 1992 Mar;31(3):313-8. http://www.ncbi.nlm.nih.gov/pubmed/1319246

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