Chronic fatigue syndrome overview

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview[edit | edit source]

Chronic fatigue syndrome (CFS) is one of several names given to a poorly understood, variably debilitating disorder of uncertain causation. CFS is thought, based on a 1999 study, to affect approximately 4 per 1,000 adults in the United States.[1]

Other names for this syndrome are:

* Myalgic Encephalomyelitis
* Systemic Exertion Intolerance Disease. Proposed by the Institute of Medicine in 2015[2][3].

For unknown reasons, CFS occurs more often in women than men, and in people in their 40s and 50s.[4][5] The illness is estimated to be less prevalent among children and adolescents, but studies are contradictory as to the degree.[6]

CFS often manifests with widespread myalgia and arthralgia, cognitive difficulties, chronic mental and physical exhaustion, often severe, and other characteristic symptoms in a previously healthy and active person. Despite promising avenues of research, there remains no assay or pathological finding which is widely accepted to be diagnostic of CFS. It remains a diagnosis of exclusion based largely on patient history and symptomatic criteria, although a number of tests can aid diagnosis.[7] Whereas there is agreement on the genuine threat to health, happiness, and productivity posed by CFS, various physicians' groups, researchers, and patient activists champion very different nomenclature, diagnostic criteria, etiologic hypotheses, and treatments, resulting in controversy about nearly all aspects of the disorder. Even the term chronic fatigue syndrome is controversial because a large part of the patient community believes the name trivializes the illness.[8]

Chronic fatigue syndrome is not the same as "chronic fatigue".[7] Fatigue is a common symptom in many illnesses, but CFS is a multi-systemic disease and is relatively rare by comparison.[9] Definitions (other than the 1991 UK Oxford criteria)[10] require a number of features, the most common being severe mental and physical exhaustion which is "unrelieved by rest" (1994 Fukuda definition),[11] and may be worsened by even trivial exertion (a mandatory diagnostic criterion according to some systems). Most diagnostic criteria require that symptoms must be present for at least six months, and all state the symptoms must not be caused by other medical conditions. CFS patients may report many symptoms which are not included in all diagnostic criteria, including muscle weakness, cognitive dysfunction, hypersensitivity, orthostatic intolerance, digestive disturbances, depression, poor immune response, and cardiac and respiratory problems. It is unclear if these symptoms represent co-morbid conditions or are produced by an underlying etiology of CFS.[12] Some cases improve over time, and treatments (though none are universally accepted) bring a degree of improvement to many others, though full resolution may be only 5-10% according to the United States Centers for Disease Control and Prevention (CDC).[13]

## References[edit | edit source]

1. ↑ Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huang CF, Plioplys S (1999). "A community-based study of chronic fatigue syndrome". Arch. Intern. Med. 159 (18): 2129–37. doi:10.1001/archinte.159.18.2129. PMID 10527290.CS1 maint: Multiple names: authors list (link)
2. ↑ Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Board on the Health of Select Populations. Institute of Medicine (2015). "Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness". The National Academies Collection: Reports funded by National Institutes of Health. doi:10.17226/19012. PMID 25695122.
3. ↑ Clayton EW (2015). "Beyond myalgic encephalomyelitis/chronic fatigue syndrome: an IOM report on redefining an illness". JAMA. 313 (11): 1101–2. doi:10.1001/jama.2015.1346. PMID 25668027.
4. ↑ Gallagher AM, Thomas JM, Hamilton WT, White PD (2004). "Incidence of fatigue symptoms and diagnoses presenting in UK primary care from 1990 to 2001". J R Soc Med. 97 (12): 571–5. doi:10.1258/jrsm.97.12.571. PMID 15574853.CS1 maint: Multiple names: authors list (link)
5. ↑
6. ↑ Jason LA, Jordan K, Miike T, Bell DS, Lapp C, Torres-Harding S, Rowe K, Gurwitt A, De Meirleir K, Van Hoof ELS (2006). "A Pediatric Case Definition for Myalgic Encephalomyelitis and Chronic Fatigue Syndrome". Journal of Chronic Fatigue Syndrome. 13 (2–3): 1–44. doi:10.1300/J092v13n02_01.CS1 maint: Multiple names: authors list (link)
7. ↑ 7.0 7.1 Carruthers BM, Jain AK, De Meirleir KL, Peterson DL, Klimas MD, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, Sherkey JA, van de Sande MI (2003). "Myalgic encephalomyalitis/chronic fatigue syndrome: Clinical working definition, diagnostic and treatment protocols" (PDF). Journal of Chronic Fatigue Syndrome. 11 (1): 7–36. doi:10.1300/J092v11n01_02.CS1 maint: Multiple names: authors list (link)
8. ↑ Jason LA, Taylor RR (2001). "Measuring Attributions About Chronic Fatigue Syndrome" (TXT). J Chronic Fatigue Syndr. 8 (3/4): 31–40. doi:10.1300/J092v08n03_04.
9. ↑ Ranjith G (2005). "Epidemiology of chronic fatigue syndrome". Occup Med (Lond). 55 (1): 13–9. doi:10.1093/occmed/kqi012. PMID 15699086.
10. ↑ Sharpe M, Archard L, Banatvala J, Borysiewicz L, Clare A, David A, Edwards R, Hawton K, Lambert H, Lane R (1991). "A report--chronic fatigue syndrome: guidelines for research". J R Soc Med. 84 (2): 118–21. PMID 1999813.CS1 maint: Multiple names: authors list (link)  PMC 1293107 Synopsis by Template:GPnotebook)
11. ↑ Fukuda K, Straus S, Hickie I, Sharpe M, Dobbins J, Komaroff A (1994). "The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group". Ann Intern Med. 121 (12): 953–9. PMID 7978722.CS1 maint: Multiple names: authors list (link)
12. ↑ Afari N, Buchwald D (2003). "Chronic fatigue syndrome: a review". Am J Psychiatr. 160 (2): 221–36. doi:10.1176/appi.ajp.160.2.221. PMID 12562565.
13. ↑

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