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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with chronic fatigue syndrome (CFS), of unknown etiology, have been increasingly reported. This syndrome is characterized by debilitating fatigue, lymphadenopathy, and fever. Herein, I focus on and review this syndrome from the view point of the causative role of viral infection. Since the symptoms of CFS are similar to those of chronic infectious mononucleosis (CIM) or chronic Epstein-Barr virus infection (CEBV), the role of EBV has been intensively studied. The etiological relationship between EBV and CFS, however, is questioned, like other lymphotropic viruses, including human retroviruses, adenoviruses and human herpesvirus 6. Additionally, severe chronic active EBV infection syndrome (SCAEBV) is also discussed in this review because symptoms of this disorder are similar to those of CFS but more severe in degree. Currently, the cause(s) and treatment of CFS are enigmatic and require further research and multidisciplinary study.
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PMID:[Viral infection and its causative role for chronic fatigue syndrome]. 133 59

We report the characteristics of 45 Epstein-Barr virus (EBV)-infected patients visiting our hospital from 1989 to 1991 in comparison with 102 patients seen from 1981 to 1988. Cases of infectious mononucleosis (IM) increased especially in patients over 30 years old. They tended to have nonspecific symptoms and signs for IM such as general fatigue. Immunologically showed twice higher positivity for anti-EBV VCA-IgM antibody in the recent 3 years when compared to the previous 8 years. The patients with anti-EBNA antibody decreased in the recent 3 years. This may be due to early diagnosis as IM. EBV also causes atypical diseases. non-IM in this report, including hematological or neurological disorders. We indicated here the increased number and advanced age of patients with IM and early diagnosis as IM in the recent 3 years compared to the previous 8 years.
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PMID:[Epidemiological analysis of infectious mononucleosis as primary Epstein-Barr virus infection]. 133 63

Infection with Epstein-Barr virus has been reported to have numerous systemic and ocular manifestations. In this study, a 38-year-old man with acute infectious mononucleosis was examined for a painless left red eye of three days' duration. The patient had a two-week history of fatigue, low-grade fever, sore throat, and lymphadenopathy. Serologic evaluation was indicative of an acute primary infection with Epstein-Barr virus. A large, salmon-colored, supranasal bulbar conjunctival mass was observed in the left eye. No associated conjunctivitis was present. Biopsy of the conjunctival lesion disclosed a dense leukocytic infiltrate, which consisted primarily of mature lymphocytes and plasma cells. Immunocytochemical evaluation of the tissue with monoclonal antisera disclosed Epstein-Barr latent membrane protein and nuclear protein 2 in a small fraction of the cells constituting the infiltrate. The conjunctival infiltrate resolved completely within one month, paralleling the regression of the patient's lymphadenopathy.
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PMID:Conjunctival lymphocytic nodule associated with the Epstein-Barr virus. 165 1

Quadriceps isometric strength, activation and fatiguability were measured in 11 patients with symptoms of fatigue three months after glandular fever or a glandular fever-like illness. Predicted normal and lower limits of normal muscle strength were calculated from height and age. These measures and the fatigue index were compared with a group of healthy students of similar age. Two of the patients were unable to activate fully their muscles. After allowing for this inhibition the group mean (SD) strength was 104 (22%) of predicted. Although there was no significant difference in the fatigue index between the patients and the control group, there was a trend for the patients to show less fatigue than controls. There was no difference in the muscle results for those patients who were found to have Epstein-Barr virus infections and those who did not. The feelings of weakness and fatigue experienced by the patients could not be explained by either physiological muscle fatigue or lack of effort.
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PMID:Human quadriceps strength and fatiguability in patients with post viral fatigue. 180 Jun 67

Epstein-Barr viral infection, specifically infectious mononucleosis, typically has a more protracted course than other acute viral illnesses. Some recent observers have additionally suggested the possibility that Epstein-Barr virus (EBV) is the etiologic infectious agent in chronic fatigue syndrome, based on the finding of higher proportions of elevated antibodies to the EBV early antigen in some patients complaining of chronic fatigue. Straus et al reported on 23 patients with chronic fatigue, 83% of whom exhibited persistently elevated antibodies in modest titer to the early antigen. Ten of these patients had never fully recovered from an episode of acute infectious mononucleosis. Other studies had noted similar associations between persistently elevated antibodies to EBV-specific antigens and chronic symptoms in patients who presented with chronic symptoms after mononucleosis. Three important antigen complexes, demonstrable by immunofluorescence procedures, are expressed in EBV-infected cells. The early antigen is thought to function perhaps in early replication of viral DNA. A late antigenic complex, the viral capsid antigen, may represent, in addition to structural capsid proteins, components of the viral enzymatic machinery for late phases of replication or transformation. The Epstein-Barr nuclear antigen is felt to function in viral transformation of host cells.
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PMID:Infectious mononucleosis, Epstein-Barr virus, and chronic fatigue syndrome: a prospective case series. 202 31

One approach to understanding the chronic fatigue syndrome might be to carry out prospective studies of fatigue that occurs following infection with viral diseases of known etiology, such as influenza, hepatitis, and infectious mononucleosis. Among the viral parameters that should be evaluated are virus burden, variation of virus strain, sites of viral replication, and the state of the viral life cycle (e.g., latent or replicative). Immunologic studies should focus on the humoral and cellular responses to defined viral gene products to identify subtle, individual variations in immune recognition of specific viral subcomponents.
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PMID:Molecular approaches to epidemiologic evaluation of viruses as risk factors for patients who have chronic fatigue syndrome. 185 May 37

In this paper the cognitive and psychiatric impairments associated with chronic fatigue syndrome (CFS) and related disorders are reviewed. It is concluded that while acute mononucleosis and infection with Epstein-Barr virus occasionally result in impaired cognition, such changes have not yet been objectively verified in patients with CFS. However, when patients with CFS are carefully studied, concurrent or premorbid psychiatric disorders are revealed at a greater than chance level. Finally, some suggestions are offered regarding improved neuropsychological assessment of fatigue, concentration, and attention for patients with CFS. The findings to date, while suggesting that psychological predisposition may play a role in the expression of CFS, are still inconclusive regarding the etiology of CFS.
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PMID:Cognitive and mood-state changes in patients with chronic fatigue syndrome. 185 May 43

Generalized adenopathy and splenomegaly developed in an 18-year-old youth after a severe tonsillitis followed by headache, tiredness and weight loss for several weeks. Infectious mononucleosis (acute Epstein-Barr virus infection) was confirmed by the demonstration of virus-specific antibodies. A reticulocytosis (24%), decreased haptoglobin concentration (0.6 mg/dl) and increased lactate dehydrogenase activity (657 U/l) indicated marked haemolysis. The bone marrow showed increased erythropoiesis with abnormal maturation. Antibodies against triosephosphate isomerase and against blood group marker "i" were demonstrated in the patient's serum. Antibodies against triosephosphate isomerase from the patient's serum were purified by affinity-chromatography. They strongly reacted with the patient's erythrocytes and under complement activation induced an increased 51Cr liberation from marked erythrocytes. No corresponding effect of anti-i-antibodies was noted at 37 degrees C. With the fall in antibodies against triosephosphate isomerase the haemolysis receded and the patient became free of symptoms after 7 weeks.
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PMID:[Infectious mononucleosis: hemolysis by autoantibodies against triosephosphate isomerase]. 217 94

Forty-one patients with recurrent fatigue were studied for evidence of symptom clustering, abnormal laboratory findings and infection with novel viruses. Symptom enquiry and investigations were repeated 4 months later. Four patients were found to have diseases compatible with their symptoms. In those remaining, an initial acute onset of symptoms was associated with an intermittent course, tender glands and a raised number of T suppressor lymphocytes. Raised numbers of T suppressor lymphocytes at follow-up correlated with resolution of symptoms. Antibodies to human herpesvirus 6 (HHV-6) were found in 75% of the patients as compared to 53% of a control group and more patients than controls were strongly seropositive. Some patients with chronic fatigue have a pattern of illness which suggests glandular fever, although acute infection with Epstein-Barr virus (EBV) is not demonstrated. Primary or reactivation infection with HHV-6 may have a role in this syndrome.
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PMID:Clinical and laboratory findings in the Paul-Bunnell negative glandular fever-fatigue syndrome. 217 87

In the 1980s, patients suffering from unexplained fatigue and what seemed like a prolonged attack of acute mononucleosis were given the diagnosis of chronic mononucleosis or chronic infection with the Epstein-Barr virus. Although the diagnosis has great appeal, the Epstein-Barr virus does not cause the syndrome (CFS) of chronic fatigue, which has been renamed and redefined chronic fatigue syndrome to remove the inference that the virus is its cause. From a historical perspective, both syndromes represent the 1980s equivalent of neurasthenia, a disease of fatigue that influenced the development of psychiatric nosology. Because patients with depression and anxiety also have chronic fatigue and because most patients with CFS have an affective disorder, the assessment of organic causes of this syndrome requires careful psychiatric diagnosis and treatment. Defining chronic fatigue syndrome as a medical disorder may deprive patients of competent treatment of their affective disorder.
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PMID:Neurasthenia in the 1980s: chronic mononucleosis, chronic fatigue syndrome, and anxiety and depressive disorders. 218 52


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