Chronic fatigue syndrome in patients with macrophagic myofasciitis

Macrophagic myofasciitis (MMF), a condition first reported in France in 1998, is defined by the presence of a stereotyped and immunologically active lesion at deltoid muscle biopsy . It was recently demonstrated that this lesion is an indicator of long-term persistence of the immunologic adjuvant aluminum hydroxide within the cytoplasm of macrophages at the site of previous intramuscular (IM) injection. MMF is typically detected in patients with diffuse arthromyalgias that have appeared subsequent to aluminum hydroxide administration in the absence of a clearly defined anatomic substratum. Patients also report unexplained chronic fatigue. These manifestations are reminiscent of the so-called chronic fatigue syndrome (CFS), a poorly understood condition manifesting as disabling fatigue, musculoskeletal pain, sleep disturbance, impaired concentration, and headaches. The present study was conducted to determine the proportion of MMF patients fulfilling international criteria for CFS.

You can read the rest of this article here: http://onlinelibrary.wiley.com/doi/10.1002/art.10740/full

 

Source: Authier FJ, Sauvat S, Champey J, Drogou I, Coquet M, Gherardi RK. Chronic fatigue syndrome in patients with macrophagic myofasciitis. Arthritis Rheum. 2003 Feb;48(2):569-70. http://onlinelibrary.wiley.com/doi/10.1002/art.10740/full (Full article)

 

MELISA-an in vitro tool for the study of metal allergy

Abstract:

The sensitizing properties of metals widely used in medical and dental care have been studied with the help of an optimized lymphocyte proliferative assay, MELISA. MELISA (memory lymphocyte immuno-stimulation assay) was originally developed for the screening of allergenic epitopes of drugs and other chemicals of low molecular weight, but has recently been adapted for the study of metal-induced sensitization.

The patients studied suffered from various oral mucosal problems which were suspected to be caused by the release of metal ions from dental restorations. They were also troubled by chronic fatigue persisting over many years. One patient was also occupationally exposed to metals while working in a dental practice. Healthy subjects without any discomfort due to metal devices served as controls. In addition to metals used in dentistry, lymphocyte responses to organic mercurials used widely as preservatives in vaccines, eye/nose drops and contact lense fluids were studied.

The results indicated that mercurials, as well as other metals such as gold or palladium, induce strong lymphocyte proliferative responses in patients with oral or systemic symptoms, but not in similarly exposed unaffected subjects.

The results of MELISA performed with a pair of identical twins with chronic fatigue syndrome (CFS) indicated that metal-specific responses may be dependent on the genetics of the patient. Thus, many metals that are today accepted for use in medicine and dentistry carry a definite sensitizing risk for certain genetically predisposed individuals. Therefore, the use of these metals should be limited in the future.

 

Source: Stejskal VD, Cederbrant K, Lindvall A, Forsbeck M. MELISA-an in vitro tool for the study of metal allergy. Toxicol In Vitro. 1994 Oct;8(5):991-1000. http://www.ncbi.nlm.nih.gov/pubmed/20693060

 

Alleged link between hepatitis B vaccine and chronic fatigue syndrome

Comment on: Alleged link between hepatitis B vaccine and chronic fatigue syndrome. [CMAJ. 1992]

 

It was with great interest that I read this article in the Jan. 1, 1992, issue of CMAJ (146: 37-38). As a 4th-year medical student at the University of Ottawa I was pleased to read of a possible medical (albeit iatrogenic) explanation for my complaints of fatigue and ill health.

You see, in my first year of medical school I was engaged in an elective in general surgery and, as a precaution, received complete hepatitis B prophylaxis. Now, some 3 years later, I find that I can hardly drag myself out of bed every morning at dawn, and it is a struggle to keep my eyes open to read Harrison’s every night, not to mention the nearly impossible task of stifling yawns and the embarrassment of nodding off at rounds and lectures after a 36-hour shift.

I also find it fascinating that most of my classmates (who have also received the hepatitis B vaccination series) have similar complaints of excessive daytime somnolence, lack of energy and listlessness as they too struggle to complete a work week in excess of 70 hours.

I am sure that the Nightingale Research Foundation would find this information very useful in its attempt to link hepatitis B vaccination with chronic fatigue syndrome. I wonder how many other medical students, interns and residents, family physicians and specialists who have received the vaccine are suffering as I am. Our voices must be heard!

~Andrew House University of Ottawa Ottawa, Ont.

 

Source: House A. Alleged link between hepatitis B vaccine and chronic fatigue syndrome. CMAJ. 1992 Apr 1;146(7):1145. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1488336/

Note: You can read the full letter here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1488336/pdf/cmaj00296-0011a.pdf