Chronic fatigue syndrome

Background

• Syndrome of chronic fatigue of unknown etiology
• Also called myalgic encephalomyelitis

CDC Diagnostic Criteria

• Severe fatigue for longer than six months, and at least four of the following symptoms:
  • Headache of new type, pattern, or severity
  • Multijoint pain without swelling or erythema
  • Muscle pain
  • Postexertional malaise for longer than 24 hours
  • Significant impairment in short-term memory or concentration
  • Sore throat
  • Tender lymph nodes
  • Unrefreshing sleep

Investigations

• Urinalysis, CBC, lytes, glucose, creatinine
• TSH, CRP, phosphorous (not sure why)
• Can also do antiendomysial antibodies for Celiac disease, rheumatoid factor, and ANA

Management

• Rule out other causes of fatigue
• Treat comorbidities
  • Sleep disturbance
  • Depression
  • Pain
• Cognitive behavioural therapy
• Graded exercise therapy