Definitions and aetiology of myalgic encephalomyelitis: how the Canadian consensus clinical definition of myalgic encephalomyelitis works

Carruthers, Bruce M.

doi:10.1136/jcp.2006.042754

Cited by 92 publications

(87 citation statements)

References 8 publications

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“…[71][72][73][74] It has been argued that no evidence points to frank adrenal insufficiency in patients with CFS, 75 and that rather than being a core feature of the illness, as has been implied, 76 neuro endocrine disturbances may simply be a secondary response to the illness.…”

Section: Hpa Dysregulation As An Epiphenomenonmentioning

confidence: 99%

Hypothalamic–pituitary–adrenal axis dysfunction in chronic fatigue syndrome

Papadopoulos¹,

Cleare²

2011

Nat Rev Endocrinol

228

153

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The weight of current evidence supports the presence of the following factors related to hypothalamic-pituitary-adrenal (HPA) axis dysfunction in patients with chronic fatigue syndrome (CFS): mild hypocortisolism; attenuated diurnal variation of cortisol; enhanced negative feedback to the HPA axis; and blunted HPA axis responsiveness. Furthermore, HPA axis changes seem clinically relevant, as they are associated with worse symptoms and/or disability and with poorer outcomes to standard treatments for CFS. Regarding etiology, women with CFS are more likely to have reduced cortisol levels. Studies published in the past 8 years provide further support for a multifactorial model in which several factors interact to moderate HPA axis changes. In particular, low activity levels, depression and early-life stress appear to reduce cortisol levels, whereas the use of psychotropic medication can increase cortisol. Addressing these factors-for example, with cognitive behavioral therapy-can increase cortisol levels and is probably the first-line approach for correcting HPA axis dysfunction at present, as steroid replacement is not recommended. Given what is now a fairly consistent pattern of findings for the type of HPA axis changes found in CFS, we recommend that future work focuses on improving our understanding of the cause and relevance of these observed changes.

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Section: Hpa Dysregulation As An Epiphenomenonmentioning

confidence: 99%

Hypothalamic–pituitary–adrenal axis dysfunction in chronic fatigue syndrome

Papadopoulos¹,

Cleare²

2011

Nat Rev Endocrinol

228

153

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“…The NICE guidelines suggest that one additional symptom should be present;4 the CDC criteria require four additional symptoms,1 2 but other criteria such as the Canadian criteria7 require the assessment of some 65 discrete symptoms, which is a significant burden on both patients and doctors. There is currently no evidence for an obvious cut-off for the number of symptoms that define CFS/ME6 and the approach used in NICE guidelines (just one additional symptom) to ensure that all patients should have access to services seems sensible.…”

Section: The Definitionmentioning

confidence: 99%

The epidemiology of chronic fatigue syndrome/myalgic encephalitis in children

Crawley

2013

Archives of Disease in Childhood

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Most paediatricians regularly see children with chronic fatigue syndrome or myalgic encephalitis (CFS/ME) in their clinics and yet we know little about how common it is, who is affected, whether there are risk factors and how likely a child is to recover (or what might predict recovery). Recent research suggests that this illness is more complicated than previously thought and that rather than being an illness found in middle class families, it is more common in those who are socially deprived. This article reviews what is currently known about this important but little understood condition.

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“…The ME/CFS and control sample sizes in this study provided greater than 90% power, with α<0.05, to detect the same frequencies of antibody reactivity previously observed in the PTLDS patients and associated controls (Chandra et al, 2010). ME/CFS patients met the Fukuda or the Canadian criteria for this condition (Carruthers, 2007; Fukuda et al, 1994) and lacked histories suggestive of Lyme disease. Screening questionnaires were used to evaluate the general health of the unaffected controls and to confirm that that they did not meet ME/CFS case definition criteria.…”

mentioning

confidence: 99%