Patients diagnosed with Myalgic encephalomyelitis/chronic fatigue syndrome also fit systemic exertion intolerance disease criteria

Abstract

Background: Myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS) remains undiagnosed in up to 91% of patients. Recently, the United States-based Institute of Medicine (IOM) developed new diagnostic criteria, naming it systemic exertion intolerance disease (SEID). Purpose: We examined how subjects fit SEID criteria and existing ME/CFS case definitions early in their illness. Methods: A total of 131 subjects fitting 1994 Fukuda CFS criteria at the time of study recruitment completed a survey of symptoms they experienced during their first 6 months of illness. Symptoms were drawn from SEID and existing criteria (1994 Fukuda, 2003 Canadian Consensus Criteria (CCC), and 2011 Myalgic Encephalomyelitis-International Consensus Criteria (ME-ICC)). We calculated and compared the number/percentage of subjects fitting single or combinations of case definitions and the number/ percentage of subjects with SEID experiencing orthostatic intolerance (OI) and/or cognitive impairment. Results: At 6 months of illness, SEID criteria identified 72% of all subjects, similar to when Fukuda criteria (79%) or the CCC (71%) were used, whereas the ME-ICC selected for a significantly lower percentage (61%, p < .001). When severity/frequency thresholds were added to the Fukuda criteria, CCC and ME-ICC, the percentage of these subjects also fitting SEID criteria increased to 93%, 97%, and 95%. Eighty-seven percent of SEID subjects endorsed cognitive impairment and 92%, OI; 79% experienced both symptoms. Conclusions: SEID criteria categorize a similar percentage of subjects as Fukuda criteria early in the course of ME/CFS and contain the majority of subjects identified using other criteria while requiring fewer symptoms. The advantage of SEID may be in its ease of use.

Onset Patterns and Course of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

“…Alternatively, peri-onset stressful events might act as the “straw that broke the camel's back,” accelerating a pathological process which was already underway. A hallmark feature of ME/CFS is post-exertional malaise (PEM), a severe and often prolonged exacerbation of multiple symptoms (e.g., muscle pain, fatigue, problems thinking, sore throat) which is out-of-proportion to the physical, cognitive, emotional, or positional stressors triggering it (6, 44, 91). PEM can be triggered by activities of daily life (e.g., showering, cooking, reading, etc.)…”

“…The objective of this study was to examine the different dimensions of ME/CFS together and fill in some of these gaps, by characterizing clinical aspects of ME/CFS in detail in one cohort of subjects based in the United States. This study will also serve as a reference for other papers derived from the same cohort (44, 45) exploring relationships among immunological, genetic, microbiological, and clinical characteristics of ME/CFS. Findings from this study may inform clinical care, help generate hypotheses about etiology, pathophysiology, diagnosis, and treatment, and assist in the design and implementation of future studies.…”

Patients with Persistent Polyclonal B-Cell Lymphocytosis Share the Symptomatic Criteria of Systemic Exertion Intolerance Disease

“…In a previous study using the same questionnaire to evaluate SEID criteria, we found that 84% of subjects self-reporting ME/CFS diagnosis mainly based on Fukuda's criteria [9] met the SEID criteria [12]. Other studies on SEID criteria have reported comparable results classifying a similar percentage of subjects among ME/CFS patients (72-88%) [22,23]. Nevertheless, the diagnostic value of SEID criteria remains controversial, being considered less specific than ME criteria [22][23][24].…”

“…Other studies on SEID criteria have reported comparable results classifying a similar percentage of subjects among ME/CFS patients (72-88%) [22,23]. Nevertheless, the diagnostic value of SEID criteria remains controversial, being considered less specific than ME criteria [22][23][24].…”

The Head-Up Tilt Table Test as a Measure of Autonomic Functioning among Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

“…These researchers found that by using the OI symptoms instead of neurocognitive impairment, only 2% more participants met the IOM criteria than if the criteria had only required cognitive impairment. A different approach was tried by Chu et al [ 25 ], but her team utilized a categorical response of “yes” and “no” to measure “feeling sick, uncomfortable, or fainting while standing.” In contrast to Jason et al’s [ 24 ] findings, Chu et al (2017) found that 92% of participants reported OI and 87% of participants endorsed cognitive impairment. Chu et al’s group operationalization of OI allowed for 13% more participants to meet the IOM criteria than if participants were required to endorse cognitive impairment alone.…”