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 precise cause of chronic fatigue syndrome isn't known. Although the cause originally was attributed to the Epstein-Barr virus, that hypothesis has since been rejected on the basis of serologic and epidemiologic observation.

Several other causative viruses have been proposed and investigated, including cytomegalovirus, herpes simplex virus types 1 and 2, human herpesvirus 6, Inoue-Melnick virus, human adenovirus 2, enteroviruses, measles virus, and a retrovirus that resembles human T-cell lymphotropic virus type II. The onset in some patients suggests a viral illness, but whether the syndrome results from a new or a reactivated infection isn't known.

Another theory holds that some symptoms may result from an overactive immune system. In addition, genetic predisposition, age, hormonal balance, neuropsychiatric factors, sex, previous illness, environment, and stress appear to have a role in the syndrome.

Signs and Symptoms

Symptoms of CFS often mimic the flu. The following are the most common symptoms of CFS. However, each individual may experience symptoms differently. Symptoms may include:

• photophobia (eye sensitivity to light)
• headache
• tender lymph nodes
• fatigue and weakness
• muscle and joint pain
• inability to concentrate
• insomnia
• ability to remember exact onset of illness
• forgetfulness
• mood swings
• confusion
• low-grade fever
• depression

The symptoms of chronic fatigue syndrome may resemble other medical conditions. Always consult your physician for a diagnosis.

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.

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 fluoxetine. A patient who has trouble sleeping or who experiences 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 is no known way to prevent CFS because a specific cause has not been found. If you have been diagnosed with CFS, follow your doctor's treatment recommendations. Try to avoid stressful situations, and seek the help of a therapist if you are troubled by depression and anxiety because of your condition.