Chronic fatigue syndrome
Description
An in-depth report on the causes, diagnosis, and treatment of chronic fatigue syndrome.
Highlights
Risk Factors
The CDC now estimates 1 million people have CFS. This may be the tip of the iceberg, since only an estimated 20% of persons with the disease have been diagnosed.
Stress has been identified as a possible trigger of CFS in people who are genetically at risk for the syndrome.
A phenomenon called central sensitization is now suspected to be the connection between fibromyalgia and CFS, which share many of the same features.
Causes
According to the CDC, the first credible evidence that CFS might have a biologic basis comes from 14 studies published in the April 2006 issue of
Pharmacogenomics.
Twenty researchers in different fields using the same data set independently linked CFS with genes involved with the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system. These genes control the body's response to trauma, injury, and other stressful events.
Diagnosis
Although no definitive test for CFS has been identified, a variety of diagnostic tests are showing promise. One uses mass spectronomy to identify suspected biomarkers of CFS. Another is aimed at identifying gene sequences unique to people with CFS. One test has succeeded in identifying certain compounds in the urine of people with CFS; one has found antibodies to the Epstein-Barr virus as well as markers of oxidative stress; another has associated shrinking gray matter in the brain with CFS. It is hoped that one or more of these tests will prove useful in diagnosing this elusive disease.
Medications
Progress has been made in finding effective medications for CFS. Recent studies have verified the value of antidepressants, particularly SSRIs, D-ribose, and antibiotics, in reducing fatigue and other symptoms of CFS. Studies of a new drug made from dsRNA have shown it to be useful in improving the ability of people with CFS to exercise. This drug is now under FDA review.
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Review Date: 1/4/2007
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Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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