Redefining the Chronic Fatigue Syndrome
Authors: Theodore G. Ganiats
Journal: Annals of Internal Medicine (2015)

Ideas and Opinions5 May 2015Redefining the Chronic Fatigue SyndromeTheodore G. Ganiats, MDTheodore G. Ganiats, MDFrom the Miller School of Medicine, University of Miami, Miami, Florida.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-0357 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The chronic fatigue syndrome, a disease that devastates patients' lives and affects between 836 000 and 2.5 million Americans (1), is often ignored or mismanaged by clinicians. The disease affects both children and adults and both males and females. Affected individuals present with persistent, intense exhaustion that worsens after physical, cognitive, or emotional effort. Even basic household chores can be exhausting, and such tasks as grocery shopping may only be possible on a "good day." People with the condition may also have trouble with cognition, finding simple questions hard to answer and describing themselves as having "brain fog" and having trouble ...References1. Jason LA, Torres-Harding SR, Njok MC. The face of CFS in the U.S. CFIDS Chronicle. 2006. Google Scholar2. Holmes GP, Kaplan JE, Gantz NM, Komaroff AL, Schonberger LB, Straus SE, et al. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988;108:387-9. [PMID: 2829679] doi:10.7326/0003-4819-108-3-387 LinkGoogle Scholar3. Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994;121:953-9. [PMID: 7978722] doi:10.7326/0003-4819-121-12-199412150-00009 LinkGoogle Scholar4. Carruthers BM, Jain AK, DeMeirleir KL, Peterson DL, Klimas NG, Lerner AM, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case definition, diagnostic and treatment protocols. J Chronic Fatigue Syndr. 2003;11:7-115. CrossrefGoogle Scholar5. Institute of Medicine. Beyond myalgic encephalomyelitis/chronic fatigue syndrome: redefining an illness. Washington, DC: National Academies Pr; 2015. Google Scholar6. Fletcher MA, Zeng XR, Maher K, Levis S, Hurwitz B, Antoni M, et al. Biomarkers in chronic fatigue syndrome: evaluation of natural killer cell function and dipeptidyl peptidase IV/CD26. PLoS One. 2010;5:e10817. [PMID: 20520837] doi:10.1371/journal.pone.0010817 CrossrefMedlineGoogle Scholar7. Lerner AM, Beqaj SH, Deeter RG, Fitzgerald JT. IgM serum antibodies to Epstein–Barr virus are uniquely present in a subset of patients with the chronic fatigue syndrome. In Vivo. 2004;18:101-6. [PMID: 15113035] MedlineGoogle Scholar8. U.S. Food and Drug Administration. The voice of the patient: chronic fatigue syndrome and myalgic encephalomyelitis. Silver Spring, MD: U.S. Food and Drug Administration; 2013. Google Scholar9. Keller BA, Pryor JL, Giloteaux L. Inability of myalgic encephalomyelitis/chronic fatigue syndrome patients to reproduce VO2peak indicates functional impairment. J Transl Med. 2014;12:104. [PMID: 24755065] doi:10.1186/1479-5876-12-104 CrossrefMedlineGoogle Scholar10. Gerrity TR, Bates J, Bell DS, Chrousos G, Furst G, Hedrick T, et al. Chronic fatigue syndrome: what role does the autonomic nervous system play in the pathophysiology of this complex illness? Neuroimmunomodulation. 2002;10:134-41. [PMID: 12481153] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Theodore G. Ganiats, MDAffiliations: From the Miller School of Medicine, University of Miami, Miami, Florida.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0357.Corresponding Author: Theodore G. Ganiats, MD, Professor, Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, 1801 NW 9th Avenue, #470, Miami, FL 33136.Author Contributions:Conception and design: T.G. Ganiats.Analysis and interpretation of the data: T.G. Ganiats.Drafting of the article: T.G. Ganiats.Critical revision of the article for important intellectual content: T.G. Ganiats.Final approval of the article: T.G. Ganiats.Administrative, technical, or logistic support: T.G. Ganiats.This article was published online first at www.annals.org on 10 February 2015. 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