Following is news of current publications
and research efforts underway
related to chronic fatigue syndrome (CFS)—also called chronic fatigue and immune dysfunction syndrome.
Genetic basis for OI
(OI), a syndrome that
may play a role in CFS, has been linked to a genetic defect. OI is characterized by lightheadedness, fatigue
and syncope and is associated with postural tachycardia and plasma norepinephrine concentrations that
are disproportionately high.
Researchers at Vanderbilt University studied identical twins, both
with symptoms of OI and disordered uptake of norepinephrine, and several members of their immediate family.
DNA analysis revealed a functional mutation in the gene encoding the norepinephrine transporter that renders
the transporter nonfunctional and causes altered heart-rate regulation and altered norepinephrine metabolism.
This in turn may lead to the symptoms of OI.
The researchers point out that the genetic mutation
does not explain all cases of OI, since it was not found to be present in 254 unrelated people, including
controls, patients with hypertension and other patients with OI.
Shannon, JR et al. Orthostatic
intolerance and tachycardia associated with norepinephrine-transporter deficiency. N Engl J Med.
2000; 342: 541-9.
Kids’ blood pressure problems documented
syndrome (POTS) has been recognized as a cause of fainting and blood pressure problems in adults with
CFS. While studying adolescents with more severe problems in autonomic tone, researchers at the Medical
College of Ohio documented a subgroup of adolescents who may also have POTS.
They found that during
a baseline tilt table test, patients demonstrated a heart rate increase of more than 30 beats per minute
within the first 10 minutes upright. This resulted in symptoms such as tachycardia, palpitations, extreme
fatigue, lightheadedness and cognitive impairment.
They concluded that POTS represents a mild,
potentially treatable form of autonomic dysfunction that can be readily identified and treated.
B et al. The postural orthostatic tachycardia syndrome: a potentially treatable cause of chronic fatigue
intolerance, and cognitive impairment in adolescents. PACE. 2000; 23: 344-51.
and urinary infections
CFS patients frequently report urinary problems, and mycoplasmas have been
investigated as a cause of CFS-like symptoms.
Researchers from the Cleveland Clinic Foundation
in Ohio recently found that infection with ureaplasma urealyticum or Mycoplasma hominis may be responsible
for a sizeable percentage of chronic urinary tract problems in women.
The researchers tested 48
women referred for complex urinary problems and possible interstitial cystitis. More than half tested
positive for mycoplasma infections, which disappeared after treatment with antibiotics.
On a symptom
severity scale from 0 (mild) to 3 (severe), the patients’ symptoms decreased from 2.2 to 0.7, and urinary
frequency decreased from 9.2 times daily to 6.8 times daily.
“After excluding anatomic, neurologic
or other infectious etiologies, we recommend culturing and treating mycoplasma in women with chronic voiding
symptoms before pursuing…more invasive diagnostic procedures,” the researchers say.
et al. Association of chronic urinary symptoms in women and ureaplasma urealyticum. Urology. 2000;
Fatigue in children
A DePaul University
research team has published
results of a screening of 12,000 households in Chicago with children ages 5-17. The results indicate that
more than 4% of those children had serious fatigue and 2% had “CFS-like” illness. The percentage of children
who had CFS is probably lower.
The study, which is published in the most recent issue of The
Journal of Chronic Fatigue Syndrome (2000, volume 6), showed that adolescents had a slightly higher
rate of CFS-like illness (2.91%) than pre-pubescent children (1.96%).
Those diagnosed with CFS-like
illness were almost evenly divided between male (47.5%) and female (52.5%). Children of Latino origin
had the highest representation in the CFS-like group.
Jordan et al. Prevalence of fatigue
and chronic fatigue syndrome-like illness in children and adolescents. J Chron Fatigue Syndrome.
2000; 6: 3-21.
Fatigue drug for MS
A recent study
involving 72 multiple sclerosis
(MS) patients showed that the drug Modanfinil relieved their severe fatigue.
Researchers from Ohio
State University College of Medicine and Kaiser Permanente in San Diego say Modanfinil causes less stimulant
effect than other drugs currently used to treat fatigue because it targets the specific regions of the
brain that control sleep and wakefulness.
The research was presented at the American Academy of
Neurology’s annual meeting in May. There is no published evidence yet that Modanfinil can relieve fatigue
in CFS patients.
Apply for award
The Dutch ME (myalgic
name for CFS) Fund is offering an award, consisting of a sculpture and 10,000 Dutch guilders, for the
best scientific article on ME/CFS. The winner will accept the award in person and give a lecture at the
award ceremony in spring 2001. Travel expenses will be covered.
Applicants must send a copy of
their article with a cover letter to the Dutch ME Fund before December 1, 2000. For details, contact the
Dutch ME Fund, Postbus 10279, 1001 EG Amsterdam, The Netherlands or e-mail to firstname.lastname@example.org.