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Subgrouping may help improve CFS research
Researchers in California suggest that dividing CFS cases
into four separate classes may help scientists compare data across studies - and
possibly provide more insight into the nature of the disease.
researchers now use the 1994 international case definition of CFS when choosing
study subjects (see back cover). But the definition is broad and based in part
on anecdotal evidence. The authors of the new paper suggest creating new
subgroups to help refine the definition: "
- Chronic fatigue with primarily nervous system disorders (impaired
- Chronic fatigue with primarily endocrine system disorders (unrefreshing
sleep, postexertional malaise);
- Chronic fatigue with primarily musculoskeletal system disorders (joint
and muscle pain); and
- Chronic fatigue with primarily immune/infectious disorders (sore
throat, tender lymph nodes).
these subgroups, the authors say, would help create more homogeneous patient
groups that would allow for data to be compared more accurately. It could also
clarify whether CFS is caused or triggered by one or a variety of different
factors. Eng MT et al. "The Case Definition of Chronic
Fatigue Syndrome." J Clin Immun. 2002; 22(1): 8-12.
Some CFS patients positive for enterovirus
Preliminary data show that some people with CFS may have an ongoing
Researchers at the Harbor-UCLA Medical Center are examining CFS patients
to see if enterovirus infections may be held in a reservoir of peripheral blood
mononuclear cells. The patients in the study meet CDC criteria for CFS, but test
negative for CFS-associated pathogens other than enterovirus.
results show that enterovirus infections may exist in some CFS patients, and
that the mononuclear cells may indeed serve as one reservoir for the infection.
Reverse-transcription-polymerase chain reaction tests (RT-PCR) tests have been
effective in detecting enteroviral RNA in a significant number of these
Epidemiological studies of enterovirus infection in CFS patients have
thus far been inconclusive.
Jou et al. "Enterovirus in chronic fatigue syndrome." Arthritis Rheum.
2001; 44(9):1788 (supplement).
CFS manual available
A new physicians'
guide on the diagnosis and treatment of CFS has been released by New Jersey
state officials. The 73-page document, A Consensus Manual for the Primary
Care and Management of Chronic Fatigue Syndrome, covers a wide range of CFS
topics - including pathophysiology, infections, pain, sleep dysfunction, GI
symptoms and behavioral rehabilitation.
manual is published by The Academy of Medicine of New Jersey, The University of
Medicine and Dentistry of New Jersey and The New Jersey Department of Health and
Senior Services. It was edited by Joseph F. John, Jr., MD. James M. Oleske, MD,
MPH, served as associate editor.
the manual may be obtained by calling the Academy of Medicine at 609-896-1901.
The manual also is scheduled to be reproduced on the Web site of The New Jersey
Department of Health and Senior Services. When posted, the manual will be found