Chronic fatigue syndrome (CFS): a syndrome of persistent incapacitating weakness or fatigue, accompanied by nonspecific somatic symptoms, lasting at least 6 months, and not attributable to any known cause.The prevalence of CFS in the U.S. is currently estimated at 800,000 (0.5% of women and 0.3% of men). Prevalence is apparently not affected by race or socioeconomic status. CFS was first defined by the U.S. Centers for Disease Control in 1988. According to the case definition as revised in 1994, CFS consists of both (1) persistent or relapsing fatigue not resulting from exertion or relieved by rest, having a clear-cut onset, lasting for at least 6 months, and causing substantial (e.g., 50% or more) reduction in the level of physical activity, and (2) simultaneous occurrence of 4 or more of the following symptoms for at least 6 months: headache, muscle pain, joint pain, sore throat, tender cervical or axillary lymph nodes, prolonged malaise after physical exertion, failure to be refreshed by sleep, and cognitive deficits (e.g., impairment of attention, concentration, and short-term memory). Physical findings are typically unremarkable. However, many patients experience postural tachycardia and delayed orthostatic hypotension. Although routine laboratory tests yield normal results in CFS, special studies have detected certain abnormalities (e.g., elevation of inflammatory cytokines, increased numbers of CD8-activated cytotoxic T cells, depression of natural killer-cell function, inactivation of the 2,5 ribonuclease-L antiviral defense pathway, and downregulation of the hypothalamic-pituitary axis manifested by low levels of ACTH and cortisol) in some but not all patients. A complex deregulation of immune response triggered by viral infection has been suggested as the cause of CFS. An influenzalike onset is more common during winter than in other seasons. Psychiatric comorbidity is common, but the current consensus is that CFS is not induced by chronic anxiety or depression. Of numerous treatments that have been used in this disorder, graded exercise and cognitive-behavioral therapy have been most effective. Tricyclic antidepressants, selective serotonin reuptake inhibitors, and nonsteroidal antiinflammatory drugs have been helpful in relieving pain and sleep problems for some patients. On long-term (e.g., 5+ years) followup, 20-50% of adult patients with CFS show some improvement but only 5-10% regain full function.
Source: Stedman's Medical Spellchecker, © 2006 Lippincott Williams & Wilkins. All rights reserved.
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