Abstract
Chronic fatigue syndrome (CFS) is characterized by unexplained fatigue lasting for more than 6 months and accompanied by flulike symptoms. It most commonly affects women aged between 30 and 60 years. To date, clear diagnostic criteria allowing for unambiguous diagno-sis of CFS have not been established. We present a case of a 57-year-old woman with chronic fatigue syndrome in order to showcase the symptoms of this condition and propose a diagnos-tic protocol.
[1] Yancey J.R., Thomas S.M., Chronic fatigue syndrome: diagnosis and treatment, Am Fam Physician., 2012, 86(8), 741–746 Search in Google Scholar
[2] Holgate S.T., Komaroff A.L., Mangan D., Wessely S., Chronic fatigue syndrome: under-standing a complex illness, Nat Rev Neurosci., 2011, 12(9), 539–544 http://dx.doi.org/10.1038/nrn308710.1038/nrn3087Search in Google Scholar PubMed
[3] Brkić S., Tomić S., Ruzić M., Marić D., Chronic fatigue syndrome, Srp Arh Celok Lek, 2011, 139(3-4), 256–261 http://dx.doi.org/10.2298/SARH1104256B10.2298/SARH1104256BSearch in Google Scholar PubMed
[4] Hunter M., Chronic fatigue syndrome could be costing UK economy pound 100m a year, study says. BMJ, 2011 10.1136/bmj.d5905Search in Google Scholar PubMed
[5] Newton J.L., Okonkwo O., Sutcliffe K., Seth A., Shin J., Jones D.E., Symptoms of auto-nomic dysfunction in chronic fatigue syndrome, QJM, 2007, 100(8), 519–526 http://dx.doi.org/10.1093/qjmed/hcm05710.1093/qjmed/hcm057Search in Google Scholar PubMed
[6] Frith J., Zalewski P., Klawe J.J., Pairman J., Bitner A., Tafil-Klawe M., Newton J.L., Im-paired blood pressure variability in chronic fatigue syndrome—a potential biomarker, QJM, 2012, 105(9), 831–838 http://dx.doi.org/10.1093/qjmed/hcs08510.1093/qjmed/hcs085Search in Google Scholar PubMed
[7] Miwa K., Fujita M., Small heart with low cardiac output for orthostatic intolerance in pa-tients with chronic fatigue syndrome, Clin Cardiol, 2011, 34(12), 782–786 http://dx.doi.org/10.1002/clc.2096210.1002/clc.20962Search in Google Scholar PubMed PubMed Central
[8] Wyller V. B., Barbieri R., Saul J.P., Blood pressure variability and closed-loop baroreflex assessment in adolescent chronic fatigue syndrome during supine rest and orthostatic stress, Eur J Appl Physiol, 2011, 111(3), 497–507 http://dx.doi.org/10.1007/s00421-010-1670-910.1007/s00421-010-1670-9Search in Google Scholar PubMed PubMed Central
[9] Hollingsworth K. G., Jones D.E.J., Taylor R., et al. Impaired cardiovascular response to standing in Chronic Fatigue Syndrome, European Journal of Clinical Investigation, 2010, 40, 608–615 http://dx.doi.org/10.1111/j.1365-2362.2010.02310.x10.1111/j.1365-2362.2010.02310.xSearch in Google Scholar PubMed
[10] Wyller B., Vagal E., With drawal during mild orthostatic stress in adolescents with chronic fatigue, A.N.E, 2008, 13, 67–73 10.1111/j.1542-474X.2007.00202.xSearch in Google Scholar PubMed PubMed Central
[11] Smit A.A., Bolweg N.M., Lenders J.W., Wieling W., No strong evidence of disturbed regulation of blood pressure in chronic fatigue syndrome. Ned Tijdschr Geneeskd, 1998,142(12), 625–628 Search in Google Scholar
[12] Dambrink J.H.A., Imholz B.P.B., Circulatory adaptation to orthostatic stress in healthy 10-14-yearold children investigated in a general practice, Clin. Sci, 1991, 81, 51–58 10.1042/cs0810051Search in Google Scholar PubMed
[13] Grubb B.P., Pathophysiology and differential diagnosis of neurocardiogenic syncope, Am. J. Cardiol, 1999, 84, 3Q–9Q http://dx.doi.org/10.1016/S0002-9149(99)00691-810.1016/S0002-9149(99)00691-8Search in Google Scholar
[14] Parry S.W., Kenny R.A., The role of tilt table testing in neurocardiovascular instability in older adults, Eur. Heart J, 2001, 22, 370–372 http://dx.doi.org/10.1053/euhj.1999.204610.1053/euhj.1999.2046Search in Google Scholar
[15] Yataco A., Talo D., Rowe P, Kass D.A., Berger. R.D., Calkins H., Comparison of heart rate variability in patients with chronic fatigue syndrome and controls, Clinical Autonomic Research, 1997, 293–297 10.1007/BF02267720Search in Google Scholar
[16] Naschitz J.E., Yeshurun D., Rosner, Dysautonomia in chronic fatigue syndrome: facts, hypotheses, implications, I.Med Hypotheses, 2004, 62(2), 203–206 http://dx.doi.org/10.1016/S0306-9877(03)00331-110.1016/S0306-9877(03)00331-1Search in Google Scholar
[17] Stewart J.M., Medow M.S., Messer Z.R., Baugham I.L., Terilli C., Ocon A.J., Postural neurocognitive and neuronal activated cerebral blood flow deficits in young chronic fatigue syndrome patients with postural tachycardia syndrome, Am J Physiol Heart Circ Physiol, 2012, 302(5), 1185–1194 http://dx.doi.org/10.1152/ajpheart.00994.201110.1152/ajpheart.00994.2011Search in Google Scholar PubMed PubMed Central
[18] Hurum H., Sulheim D., Thaulow E., Wyller V.B., Elevated nocturnal blood pressure and heart rate in adolescent chronic fatigue syndrome, Acta Paediatr, 2011, 100(2), 289–292 http://dx.doi.org/10.1111/j.1651-2227.2010.02073.x10.1111/j.1651-2227.2010.02073.xSearch in Google Scholar PubMed
[19] Sutcliffe K., Gray J., Tan M.P., Pairman J., Wilton K., Parry S.W., Newton J.L., Home orthostatic training in chronic fatigue syndrome—a randomized, placebo-controlled feasibility study, Eur J Clin Invest, 2010, 40(1), 18–24 http://dx.doi.org/10.1111/j.1365-2362.2009.02225.x10.1111/j.1365-2362.2009.02225.xSearch in Google Scholar PubMed
[20] Wyller V.B., Saul J.P., Walløe L., Thaulow E., Sympathetic cardiovascular control during orthostatic stress and isometric exercise in adolescent chronic fatigue syndrome, Eur J Appl Physiol, 2008, 102(6), 623–632 http://dx.doi.org/10.1007/s00421-007-0634-110.1007/s00421-007-0634-1Search in Google Scholar PubMed
[21] Naschitz J., Fields M., Isseroff H., Sharif D., Sabo E., Rosner I.J, Shortened QT interval: a distinctive feature of the dysautonomia of chronic fatigue syndrome, Electrocardiol, 2006 39(4), 389–394 http://dx.doi.org/10.1016/j.jelectrocard.2005.10.01410.1016/j.jelectrocard.2005.10.014Search in Google Scholar PubMed
[22] Jones J.F., Nicholson A., Nisenbaum R., Papanicolaou D.A., Solomon L., Boneva R., Heim C., Reeves W.C., Orthostatic instability in a population-based study of chronic fatigue syndrome, Am J Med, 2005, 118(12), 1415 http://dx.doi.org/10.1016/j.amjmed.2005.06.01310.1016/j.amjmed.2005.06.013Search in Google Scholar PubMed
[23] Winkler A.S., Blair D., Marsden J.T., Peters T.J., Wessely S., Cleare A.J., Autonomic function and serum erythropoietin levels in chronic fatigue syndrome, J Psychosom Res, 2004 56(2), 179–183 http://dx.doi.org/10.1016/S0022-3999(03)00543-910.1016/S0022-3999(03)00543-9Search in Google Scholar
[24] LaManca J.J., Peckerman A., Walker J., Kesil W., Cook S., Taylor A., Natelson B.H., Cardiovascular response during head-up tilt in chronic fatigue syndrome, Clin Physiol, 1999, 19(2), 111–120 http://dx.doi.org/10.1046/j.1365-2281.1999.00154.x10.1046/j.1365-2281.1999.00154.xSearch in Google Scholar
[25] Schondorf R., Benoit J., Wein T., Phaneuf D.J., Orthostatic intolerance in the chronic fatigue syndrome, Auton Nerv Syst, 1999, 75(2-3), 192–201 http://dx.doi.org/10.1016/S0165-1838(98)00177-510.1016/S0165-1838(98)00177-5Search in Google Scholar
[26] Schondorf R., Freeman R., The importance of orthostatic intolerance in the chronic fa-tigue syndrome, Am J Med Sci, 1999, 317(2), 117–123 http://dx.doi.org/10.1097/00000441-199902000-0000610.1097/00000441-199902000-00006Search in Google Scholar
[27] Stewart J., Weldon A., Arlievsky N., Li K., Munoz J., Neurally mediated hypotension and autonomic dysfunction measured by heart rate variability during head-up tilt testing in children with chronic fatigue syndrome, Clin Auton Res, 1998, 8(4), 221–230 http://dx.doi.org/10.1007/BF0226778510.1007/BF02267785Search in Google Scholar
[28] De Becker P., Dendale P, De Meirleir K., Campine I., Vandenborne K., Hagers Y., Au-tonomic testing in patients with chronic fatigue syndrome, Am J Med. 1998, 105(3A), 22S–26S http://dx.doi.org/10.1016/S0002-9343(98)00168-510.1016/S0002-9343(98)00168-5Search in Google Scholar
[29] De Lorenzo F., Hargreaves J., Kakkar V.V., Pathogenesis and management of delayed orthostatic hypotension in patients with chronic fatigue syndrome, Clin Auton Res, 1997 7(4), 185–190 http://dx.doi.org/10.1007/BF0226798010.1007/BF02267980Search in Google Scholar PubMed
© 2013 Versita Warsaw
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.