TO TABLE OF
The latest information on
research, treatment and diagnosis of CFIDS
A study published
in the January 24 issue of Archives of Internal Medicine looked at approximately 100 patients
with chronic fatigue syndrome (CFS), fibromyalgia (FM), or temporomandibular joint disorder (TMJ) to determine
whether they shared symptoms in common, or suffered from over-lapping conditions. Researchers relied on
patients' self-reporting of whether they had been diagnosed with any of 10 other conditions, as well as
The study found that individuals with CFS, FM or TMJ often suffer from other overlapping
conditions that are not diagnosed, including interstitial cystitis and chronic tension-type headache.
Irritable bowel syndrome in particular was underdiagnosed in all three groups (it was a missed diagnosis
in 92% of the CFS patients).
The patients also shared a number of symptoms, including generalized
pain sensitivity, sleep and concentration difficulties and gastrointestinal complaints. But the conditions
also presented a number of distinguishing symptoms. Patients with CFS and FM had fatigue, joint aches
and burning or shooting muscle pain while patients with TMJ did not. Unique symptoms for CFS included
fever or sore throat; for FM, a more frequent history of low back pain.
Seasonal onset of CFS?
recent research papers
have suggested that onset of CFS may be tied to particular times of the year. A small study published
in January 2000 issue of the journal Chronobiology International looked at the dates when 69
patients whose onset was sudden (over a two-day period) became ill.
The onset dates were distinctly
nonrandom---peaking from November through January and lowest from April through May. This supports the
hypothesis that infectious illness may trigger the onset of CFS.
Similar findings were published
in the March 2000 issue of the Journal of the Royal Society of Medicine. Researchers found that
the majority of 50 British children with CFS developed the illness between September and December. Study
authors speculate that because the children were on average 11 years old, the onset may coincide with
the beginning of secondary school and an increased risk for stress and infection.
Impact of psychiatric
If you think your
physician is writing your medical complaints off to psychiatric problems, you might be right. A study
published in the March 2000 issue of The Journal of General Internal Medicine shows doctors are
less likely to suspect serious illness in patients with a history of depression or mental disorders.
at the University of Iowa mailed questionnaires presenting two hypothetical patient cases to 300 randomly
selected family doctors and asked for their "recommendations." The cases involved sudden onset of severe
headaches or abdominal pain. One group of doctors received no additional information about the patients,
the other group was told the patients had a history of unexplained physical symptoms. Doctors who were
told of the patients' histories were significantly less likely to think there might be a serious problem
and order further tests.
Long-term symptom patterns
A study of 398 patients
who have had CFS for more than 10 years has shown that those individuals report a larger number of specific
cognitive problems that are greater in severity than those reported by individuals who were ill for a
shorter period of time (less than seven years).
This was the first published study to describe
a large sample of patients with a long duration of illness. Most of the long-term sufferers, who had been
ill an average of 16 years, experienced onset at a young age and showed a higher percentage of infection
with viral and immune-related illnesses, including allergies, chronic sinus infections, mononucleosis
and hepatitis. The long-term patient group also reported higher rates of depression and fibromyalgia,
which may further the level of impairment.
The study, published in the Journal of Psychosomatic
Research (vol. 48, 2000: 59-68), was funded by The CFIDS Association of America.
Please keep in mind
that research studies with less
than 500 patients are generally not considered statistically valid and may be questioned by the medical
community. The Chronicle reports on smaller studies due to the lack of large-scale research projects being
funded and to keep you updated on emerging trends that may become the focus of larger studies later on.
Texas Researchers studying new microbe
By Larry Northon
A Texas laboratory, Pathobiotek Diagnostics,
linked a newly-discovered bacterium to CFS and multiple sclerosis. Dr. Luther Lindner, MD, PhD, Patho-biotek’s
Vice President and Chief Scientific Officer and a patho-logist at Texas A&M University, says that
his lab has found the bacterium in high numbers in individuals with autoimmune disorders. He will not
say whether Luey actually may cause CFS or other illnesses.
Unfortunately, if Luey does play a
role in causing illness, it may be difficult to eradicate. Dr. Lindner claims that Luey is very antibiotic-resistant
and that antibiotics only seem to bring remission in fewer than 25 percent of CFS patients treated.
Lindner gave a poster presentation on the Luey bacterium at the United States and Canadian Academy of
Pathology conference in March, and says that his lab will be submitting a paper to a major medical journal