Chronic Fatigue and Immune Dysfunction Syndrome

Also called chronic fatigue syndrome, chronic Epstein-Barr virus, myalgic encephalomyelitis, and Yuppie flu, this syndrome is characterized by incapacitating fatigue. The patient's symptoms may wax and wane, but they're often severely debilitating and can last for months or years.

Although most prevalent among professionals in their 20s and 30s, the syndrome affects people of all ages, occupations, and income levels. The diagnosis is more common in women than in men or children, especially women under age 45. Sporadic incidence and epidemic clusters have been observed.

Causes

The causes of CFS are still not clear. There are a number of theories that have been proposed, the main ones propose the following factors as the cause:

• Viral Infection
• Mycoplasma Infection
• Immune or Endocrine Dysfunction
• Autonomic Nervous System Dysfunction
• Environmental Toxins
• Genetic Factors
• Candida Overgrowth/Gut Dysbiosis
• Heavy Metal Sensitivity
• Emotional Stress or Trauma

Symptoms and Signs

Although the symptoms here to fore listed are the official diagnostic criteria, many patients with CFS present a variety of other symptoms, including:

• Pain
  
• Allergies
  
• Chemical sensitivities
  
• Secondary infections, including Candida and viral infections
  
• Cognitive impairment, including short-term memory loss, difficulty concentrating and doing word searches and math problems
  
• Digestive disturbances, such as chronic constipation or diarrhea
  
• Night sweats or spontaneous daytime sweats, unaccompanied by fever
  
• Headaches, migraines
  
• Weakness, muscle fatigue, and pain
  
• Premenstrual syndrome (PMS)

Diagnostic tests

No definitive test exists for this disorder. Diagnostic testing should include tests to rule out other illnesses, such as Epstein-Barr virus. leukemia, and lymphoma.

Some patients with chronic fatigue syndrome have reduced natural killer cell cytotoxicity, abnormal CD4:CD8 T-cell ratios, decreases in immunoglobulin subclasses, mild lymphocytosis, circulating immune complexes, and increased levels of antimicrosomal antibodies. But because these findings vary from patient to patient, they're of uncertain clinical significance.

A psychiatric screening may aid diagnosis because many patients have an underlying psychiatric disorder. Also, they commonly experience depression and anxiety after the syndrome's onset.

Treatment

Treatment focuses on supportive care. The patient with myalgia or arthralgia can benefit from nonsteroidal anti-inflammatory drugs. A patient who sleeps excessively can receive an antidepressant such as fluoxetina. A patient who has trouble sleeping or who experience pain may benefit from amitriptyline.

Nonsteroidal anti-inflammatory drugs may relieve headache, diffuse pain, and fever. Antihistamines can also help relieve symptoms. Psychiatric evaluation may be helpful. Unproved treatments should be avoided. Behavior therapy may be helpful.

Prevention

There are no prevention.

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