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Sarah Marriott - One of the best experts on this subject based on the ideXlab platform.

  • Chronic Fatigue Syndrome or affective disorder? Implications of the diagnosis on management
    European Child & Adolescent Psychiatry, 1994
    Co-Authors: Joanna Giannopoulou, Sarah Marriott
    Abstract:

    Es wird ein 13 1/2 Jahre alter Junge mit einer “bipolaren”, manisch-depressiven Krankheit beschrieben, die kurz nach viralen Symptomen begann und deswegen als Postvirales Ermüdungssyndrom betrachtet wurde. Die differential-diagnostischen Schwierigkeiten der Unterscheidung zwischen affektiven Krankheiten und Postviralem Ermüdungssyndrom im Jugendalter werden beleuchtet. Die Konsequenzen einer falschen Diagnose bei Jugendlichen angesichts der Entwicklungsaufgaben dieses Alters werden erörtert. This paper reports a case of a 13 1/2 year old boy with a bipolar affective disorder, who was assumed to be suffering from a post-viral Fatigue Syndrome. The diagnostic problems in differenting the Postviral Fatigue Syndrome from affective disorders in children/adolescents are discussed. The consequences of misdiagnosis in young people, bearing in mind the developmental tasks that they face, are considered. Cet article décrit le cas d'un garcon, âgé 13 1/2 ans avec un trouble affectif bipolaire. Sa maladie, précédée par une épisode de symptômes viraux, était diagnostiquée erronément comme syndrôme de Fatigue post-viral. Les problèmes du diagnostic-differentiel de la distinction entre syndrômes de Fatigues et maladies affectives dans la jeunesse/ad-olescence, sont mis au lumière. Les conséquences d'un faux diagnostic dans la jeunesse, peuvent être graves, tenant compte des tâches développementales de cet âge.

  • Chronic Fatigue Syndrome or affective disorder? Implications of the diagnosis on management
    European child & adolescent psychiatry, 1994
    Co-Authors: Joanna Giannopoulou, Sarah Marriott
    Abstract:

    This paper reports a case of a 13 1/2 year old boy with a bipolar affective disorder, who was assumed to be suffering from a post-viral Fatigue Syndrome. The diagnostic problems in differenting the Postviral Fatigue Syndrome from affective disorders in children/adolescents are discussed. The consequences of misdiagnosis in young people, bearing in mind the developmental tasks that they face, are considered.

Joanna Giannopoulou - One of the best experts on this subject based on the ideXlab platform.

  • Chronic Fatigue Syndrome or affective disorder? Implications of the diagnosis on management
    European Child & Adolescent Psychiatry, 1994
    Co-Authors: Joanna Giannopoulou, Sarah Marriott
    Abstract:

    Es wird ein 13 1/2 Jahre alter Junge mit einer “bipolaren”, manisch-depressiven Krankheit beschrieben, die kurz nach viralen Symptomen begann und deswegen als Postvirales Ermüdungssyndrom betrachtet wurde. Die differential-diagnostischen Schwierigkeiten der Unterscheidung zwischen affektiven Krankheiten und Postviralem Ermüdungssyndrom im Jugendalter werden beleuchtet. Die Konsequenzen einer falschen Diagnose bei Jugendlichen angesichts der Entwicklungsaufgaben dieses Alters werden erörtert. This paper reports a case of a 13 1/2 year old boy with a bipolar affective disorder, who was assumed to be suffering from a post-viral Fatigue Syndrome. The diagnostic problems in differenting the Postviral Fatigue Syndrome from affective disorders in children/adolescents are discussed. The consequences of misdiagnosis in young people, bearing in mind the developmental tasks that they face, are considered. Cet article décrit le cas d'un garcon, âgé 13 1/2 ans avec un trouble affectif bipolaire. Sa maladie, précédée par une épisode de symptômes viraux, était diagnostiquée erronément comme syndrôme de Fatigue post-viral. Les problèmes du diagnostic-differentiel de la distinction entre syndrômes de Fatigues et maladies affectives dans la jeunesse/ad-olescence, sont mis au lumière. Les conséquences d'un faux diagnostic dans la jeunesse, peuvent être graves, tenant compte des tâches développementales de cet âge.

  • Chronic Fatigue Syndrome or affective disorder? Implications of the diagnosis on management
    European child & adolescent psychiatry, 1994
    Co-Authors: Joanna Giannopoulou, Sarah Marriott
    Abstract:

    This paper reports a case of a 13 1/2 year old boy with a bipolar affective disorder, who was assumed to be suffering from a post-viral Fatigue Syndrome. The diagnostic problems in differenting the Postviral Fatigue Syndrome from affective disorders in children/adolescents are discussed. The consequences of misdiagnosis in young people, bearing in mind the developmental tasks that they face, are considered.

Leonard C. Archard - One of the best experts on this subject based on the ideXlab platform.

  • Persistence of enterovirus RNA in muscle biopsy samples suggests that some cases of chronic Fatigue Syndrome result from a previous, inflammatory viral myopathy.
    Journal of medicine, 1993
    Co-Authors: N E Bowles, D Doyle, L Cunningham, Hongyi Zhang, T. A. Bayston, R. J. M. Lane, Leonard C. Archard
    Abstract:

    Molecular hybridization using an enterovirus group specific probe detected virus RNA in muscle biopsy samples from 25 of 96 cases of inflammatory muscle disease and similarly from 41 of 158 cases of Postviral Fatigue Syndrome (PFS). Enterovirus RNA was detected in only two of 152 samples of control muscle. The inflammatory myopathy group comprised patients with polymyositis (PM), juvenile dermatomyositis (JDM) or adult dermatomyositis (DM), and all showed the presence of an inflammatory infiltrate and fiber necrosis on histological examination of a muscle biopsy sample. In contrast, muscle samples from the PFS group were histologically normal except for non-specific changes such as occasional single fiber atrophy. By analogy with enteroviral myocarditis, which can progress to a post-inflammatory disease with persistence of virus in myocardium and disposes to the rapid development of dilated cardiomyopathy, we propose that PFS Syndrome may be a sequela of a previous inflammatory viral myopathy.

  • Persistent Virus Infection of Muscle in Postviral Fatigue Syndrome
    British medical bulletin, 1991
    Co-Authors: L Cunningham, Neil E. Bowles, Leonard C. Archard
    Abstract:

    Nucleic acid was extracted from muscle biopsy samples from a series of highly selected patients suffering from chronic muscle fatiguability following a viral infection (Postviral Fatigue Syndrome: PVFS). Samples were examined for the presence of enteroviral RNA sequences or Epstein-Barr (EBV) virus DNA sequences by molecular hybridisation as these two agents have been implicated by retrospective serology in the aetiology of PVFS. We found enteroviral RNA in 24% of biopsy samples and EBV DNA in a further 9% of biopsy samples: no biopsy was positive for both enteroviral RNA and EBV DNA. In addition, in the case of enteroviruses we found that the persisting virus is defective in control of RNA replication as both strands of enteroviral RNA are present in similar amounts: this is unlike the asymmetric synthesis of genomic RNA seen in a productive, cytolytic enterovirus infection. The implications of these data in relation to mechanisms of viral persistence and muscle dysfunction are discussed.

Simon Wessely - One of the best experts on this subject based on the ideXlab platform.

  • Chronic Fatigue Syndrome
    Encyclopedia of Life Sciences, 2001
    Co-Authors: Anthony J. Cleare, Simon Wessely
    Abstract:

    Chronic Fatigue Syndrome represents an operationally defined condition with substantial, disabling and prolonged Fatigue as its main symptom. It has a prevalence of about 1% and makes a substantial public health impact. Keywords: CFS; myalgic encephalomyelitis; ME; Postviral Fatigue Syndrome; chronic Fatigue and immune dysfunction Syndrome (CFIDS)

  • Postviral Fatigue Syndrome
    1992
    Co-Authors: Anthony J. Pelosi, Anthony S. David, Simon Wessely
    Abstract:

    The clinical Syndrome history epidemiology neurophysiology muscle pathology and biochemistry immunology mechanisms of persistent viral infections viral persistence in muscle use of polymerase chain reaction as an investigative tool in PVFS research psychiatry and aetiology of PVFS treatment of PVFS psychiatric management current neurobiology perspective current psychiatric perspectives.

  • History of Postviral Fatigue Syndrome.
    British medical bulletin, 1991
    Co-Authors: Simon Wessely
    Abstract:

    In writing a history of any illness there is always a dilemma whether to attempt the story of the condition 'itself, the medical attempts to define its nature, or to glimpse it via our changing reactions. The easiest is a straightforward account of the attempts of scientists to solve a problem— the classic medical detective story. However, this is often more fiction than fact. Medicine rarely moves smoothly from ignorance to knowledge, but often in a more circular fashion. A historical approach is thus not solely a record of who did what, but also contributes to our understanding of the problems under scrutiny in this issue. Terminology is never easy in this subject, but the following conventions will be used: The terms neurasthenia and ME will be used in their actual context (as authors themselves used them), without defining either. Post-infectious Fatigue Syndrome (PIFS) will cover similar conditions when related to infective episodes. All will be used in a neutral fashion, to refer to changing realities as understood by doctors and historians. This chapter attempts both chronological description and social analysis. The justification for this approach is clear in the case of neurasthenia, since 'as so little was known of its pathological basis physicians' statements regarding the disease were composed more of social and cultural elements than of scientific knowledge'.1 Although much has changed, a contemporary account still reveals as much about cultural attitudes as the advance of science.2

  • Chronic Fatigue Syndrome: signs of a new approach.
    British journal of hospital medicine, 1991
    Co-Authors: A. David, Simon Wessely, Anthony J. Pelosi
    Abstract:

    Persistent media highlighting of the plight of patients suffering from severe Fatigue of unknown cause (Postviral Fatigue Syndrome or myalgic encephalomyelitis) has at last been matched by professional attention. Recent research has started to clarify the roles of infective, neuromuscular and psychiatric factors in the illness, but pathophysiological mechanisms remain obscure.

P O Behan - One of the best experts on this subject based on the ideXlab platform.

  • Mitochondrial abnormalities in the Postviral Fatigue Syndrome
    Acta Neuropathologica, 1991
    Co-Authors: Wilhelmina M.h. Behan, I. A. R. More, P O Behan
    Abstract:

    We have examined the muscle biopsies of 50 patients who had Postviral Fatigue Syndrome (PFS) for from 1 to 17 years. We found mild to severe atrophy of type II fibres in 39 biopsies, with a mild to moderate excess of lipid. On ultrastructural examination, 35 of these specimens showed branching and fusion of mitochondrial cristae. Mitochondrial degeneration was obvious in 40 of the biopsies with swelling, vacuolation, myelin figures and secondary lysosomes. These abnormalities were in obvious contrast to control biopsies, where even mild changes were rarely detected. The findings described here provide the first evidence that PFS may be due to a mitochondrial disorder precipitated by a virus infection.

  • Antibody to Coxsackie B virus in diagnosing Postviral Fatigue Syndrome.
    BMJ (Clinical research ed.), 1991
    Co-Authors: N A Miller, R A Mccartney, H A Carmichael, B.d. Calder, P O Behan, Eleanor J. Bell, F C Hall
    Abstract:

    OBJECTIVE--To study the association between coxsackie B virus infection and the Postviral Fatigue Syndrome and to assess the immunological abnormalities associated with the Syndrome. DESIGN--Case-control study of patients with the Postviral Fatigue Syndrome referred by local general practitioners over one year. SETTING--General practitioner referrals in Dunbartonshire, Scotland. PATIENTS--254 Patients referred with the Postviral Fatigue Syndrome (exhaustion, myalgia, and other symptoms referable to Postviral Fatigue Syndrome of fairly recent onset--that is, several months) and age and sex matched controls obtained from same general practitioner; 11 patients were rejected because of wrong diagnoses, resolution of symptoms, and refusal to participate, leaving 243 patients and matched controls. MAIN OUTCOME MEASURES--Detailed questionnaire (patients and controls) and clinical examination (patients) and blind analysis of blood sample at entry and after six months for determination of coxsackie B virus IgM and IgG antibodies and other variables (including lymphocyte protein synthesis, lymphocyte subsets, and immune complexes). RESULTS--Percentage positive rates for coxsackie B virus IgM at entry were 24.4% for patients and 22.6% for controls and for coxsackie B virus IgG 56.2% and 55.3% respectively; there were no significant differences between different categories of patients according to clinical likelihood of the Syndrome nor any predictive value in a fourfold rise or fall in the coxsackie B virus IgG titre in patients between entry and review at six months. The rates of positive antibody test results in patients and controls showed a strong seasonal variation. Of the numerous immunological tests performed, only a few detected significant abnormalities; in particular the mean value for immune complex concentration was much higher in 35 patients and 35 controls compared with the normal range and mean value for total IgM was also raised in 227 patients and 35 controls compared with the normal range. CONCLUSIONS--Serological tests available for detecting coxsackie B virus antibodies do not help diagnose the Postviral Fatigue Syndrome. Percentage positive rates of the antibodies in patients simply reflect the background in the population as probably do the raised concentrations of total IgM and immune complexes.

  • Clinical spectrum of Postviral Fatigue Syndrome
    British medical bulletin, 1991
    Co-Authors: P O Behan, A. M. O. Bakheit
    Abstract:

    Many different neurological and psychiatric Syndromes follow viral infections, but their clinical pictures and pathogeneses are poorly understood. The Syndromes include acute disseminated encephalomyelitis (post-infectious encephalomyelitis), the Guillain-Barre Syndrome (post-infectious neuritis) and Reye's Syndrome. Recently, attention has been focused on another common Postviral neurological Syndrome, i.e. the Postviral Fatigue Syndrome (PVFS)--termed myalgic encephalomyelitis (ME) and a host of other designations. PVFS occurs both sporadically and in epidemics, with cases being reported from all over Europe, the United States, Australasia and South Africa. It is difficult to make the diagnosis and this has meant, in the past, that it is not until an epidemic has occurred that random cases which presented in the preceding years are realised to represent the same condition. With renewed interest in the Syndrome and greater attention from physicians, however, diagnosis of sporadic cases is now becoming more common.