Chronic fatigue syndrome (CFS): Review of clinical data of 107 cases. CFS means several, diverse and partially coinciding events which share the same pathophysiological pathways that finally result in this clinical syndrome.

Date:   3/5/2005 9:06:18 PM ( 19 y ago)

Wagner M, Krueger GRF, Ablashi DV, et al

Síndrome de fatiga crónica(SFC): Revisión de los datos clínicos de
107 casos

Rev Med Hosp Gen Mex 1998; 61(4): 195-210.

Chronic fatigue syndrome (CFS): Review of clinical data of 107 cases


ABSTRACT

One hundred and seven patients with clinical "CFS" between 7 and 76 years old (medium age 41.8 yrs.) were studied. Sixty were female and 47 were male (F/M ratio 1.27:1). Follow-up periods lasted from 10
months to 7.5 years. Patients were recruited for the study by
answering a standard questionaire (appendix), and by matching the
Holmes' criteria for CFS. This was followed by physical examination, hematological and chemistry test, lymphocyte phenotyping and control of other immunologic parameters, as well as assays for various
infections.


One patient was diagnosed to have eosinophilia myalgia syndrome, 6 patients had vitamin D3 (25-OH) deficiency, and symptoms receded
after replacement therapy. Of the remaining 100 patients, 4 had
previous psychiatric episodes. In 67% of the CFS patients, there was a proven evidence of persistent or recurrent active infection, while additional 16% had suggestive infections. The most frequently active infection detected was human herpesvirus-6 (HHV-6) in 38.6%, followed by Epstein-Barr virus (EBV) in 19.6%, The less frequent ones were
herpes simplex virus (HSV), chlamydia, campylobacter, coxsackie,
cytomegalovirus (CMV), yersinia or candida.


In 46% of the patients there were signs of immune deficiency, while in additional 20% the evidence was less clear consisting for example in decreased lymphocyte stimulation (phytohematoaglutinin-PHA/ConA 46%), low natural killer (NK) cell levels (35%)and low CD4/CD8 cell ratios (21%). Fourteen to 21% of the patients had laboratory signs of ongoing infectious diseases, allergies or autoimmune disorders
including increase in the levels of tumor necrosis factor (sTNFa)
(41%), positive C reactive protein (CRP) (19.4%), and elevated IgE levels (14.3%). Patients with certain allergic or autoimmune
reactions had also signs of infection. There were 6.4% to 23.4% of CFS patients with unidentified pathogenesis. This data confirm
Demitrak's concept of CFS, that there is no single etiologic event leading to the CFS disease, but that there are several, diverse and partially coinciding events which share the same pathophysiological pathways that finally result in this clinical syndrome.

Key words: Chronic fatigue syndrome, CFS, human herpes viruses.





 

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