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

Eleven patients of Chinese origin experienced spontaneous reactivation of chronic active hepatitis B. Eight HBsAg-positive patients were followed for an average of 15 months prior to, while three others presented during reactivation. Fatigue, hepatomegaly and jaundice were frequent findings. Elevation of both serum ALT (average = 1,212 units per liter) and hepatitis B virus DNA levels were noted in all patients, and reactivation lasted an average of 4.4 months. During resolution, clinical symptoms abated, serum ALT levels reverted toward normal, and in nine patients, the hepatitis B virus DNA values became undetectable. All patients lacked evidence for acute hepatitis A, Epstein-Barr Virus, cytomegalovirus or hepatitis delta virus infection. Histologic findings of liver tissue from eight patients showed piecemeal necrosis and fibrosis. Within the parenchyma, varying degrees of hepatocytolysis with cuffing, perivenular necrosis and acidophilic bodies were noted. Ground-glass cells and regenerative changes also were observed. Cirrhosis was not present in any of the liver biopsies. These findings suggest that spontaneous reactivation of hepatitis B occurs in heterosexual patients with chronic active hepatitis B and contributes to chronic inflammation and to the progression of their liver disease.
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PMID:Spontaneous reactivation of hepatitis B in Chinese patients with HBsAg-positive chronic active hepatitis. 361 49

Although most adolescents who complain of fatigue do not have a serious medical illness, the complaint cannot be dismissed without further investigation. If the diagnosis remains uncertain after a careful history and a thorough physical examination, laboratory tests, including complete blood count, erythrocyte sedimentation rate, urinalysis and an Epstein-Barr antibody profile, may be considered next. If the etiology is still unclear, sequential visits often provide clues for the physician and reassurance for the family.
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PMID:Evaluating adolescents with fatigue. 382 44

Outbreaks of epidemic neuromyasthenia have occurred throughout the world for many years, but sporadic cases have only recently been recognized. Fifty consecutive previously well patients with prolonged and excessive fatigue after an apparent acute infection were investigated. Most were well educated, active, unmarried women aged 30 to 40 years. The precipitating infection had many clinical presentations. The chronic phase of the illness was characterized by a fairly common set of symptoms. Physical examination and laboratory testing generally gave normal results. Of the 50 patients 16 were found to be infected with Epstein-Barr virus, 7 with other viruses, 4 with parasites and 2 with Mycoplasma pneumoniae. The causative agent was not known in 22 cases. The mean duration of the illness was 27.6 months, and the mean proportion of time lost from work or school was 39%. Drug therapy was not beneficial; supportive therapy was useful. Further investigation is required to determine optimal management of sporadic neuromyasthenia.
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PMID:Sporadic postinfectious neuromyasthenia. 404 36

We present data on 14 patients with chronic symptoms of disabling fatigue in association with serologic evidence of active Epstein-Barr virus (EBV) infection. Two thirds were women, and the average age at onset was 29.6 years. Forty-three percent were known to have had previous infectious mononucleosis, but the usual criteria for that diagnosis were not helpful with the present syndrome. Eighty-six percent had serologic evidence of cytomegalovirus (CMV) infection. Profound immunodeficiency was not present, but 71% had partial hypogammaglobulinemia, and minor abnormalities of T cell subsets were noted in six of seven patients studied. Fifty-seven percent achieved temporary serologic and symptomatic remission after an average duration of 33 months. Only one patient has a sustained remission. Comparison is made with other reported chronic, recurrent, and persistent EBV syndromes, and tentative diagnostic criteria for chronic mononucleosis syndrome are presented. Recently available EBV serologic techniques allow for identification of patients who have reactivated EBV infection, and this reactivation may be related to symptoms.
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PMID:Chronic mononucleosis syndrome. 609 68

Malignant histiocytosis is characterized by systemic, progressive, and invasive proliferation of malignant histiocytes. The disorder is typically accompanied by fever, general fatigue, lymphadenopathy, and hepatosplenomegaly. A case of a 21-year-old woman with primary malignant histiocytosis of the oropharynx is reported. Histologic diagnosis from the biopsy specimen was confused by infiltration of normal-appearing histiocytes and inflammatory cells. The titers of Epstein-Barr virus and the Paul-Bunnell test were elevated without atypical lymphocytes. The patient died 3.5 months after the onset of symptoms. Autopsy revealed systemic neoplastic proliferation of malignant histiocytes. A review of literature on this subject revealed no cases of malignant histiocytosis primarily involving the oropharynx.
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PMID:Malignant histiocytosis in the oropharynx. 647 63

A syndrome of chronic mononucleosis occurred in two members of a family. Symptoms were chronic malaise and fatigue; recurrent upper respiratory tract infections; and mild, variable immune abnormalities. Intermittently positive heterophil titers were present for more than 2 years after acute infectious mononucleosis. Epstein-Barr-virus-specific antibodies were persistently abnormal. In the proband, the R component of the early antigen complex was present for 3 years and she never developed normal antibodies to Epstein-Barr nuclear antigen. Her brother had low to absent Epstein-Barr nuclear antigen titers, and antibodies to both the R and D component of the early antigen complex. Primary and acquired immunodeficiency states can show abnormal Epstein-Barr-virus-specific serologic findings that may reflect an attempt by the host to limit virus spread in the presence of deficient immune responses. This action may result in alterations of the Epstein-Barr virus-latent state, and lead to a chronic active infection and a syndrome of chronic mononucleosis.
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PMID:Familial chronic mononucleosis. 714 89

Epstein-Barr virus (EBV) belongs to the group of herpesvirus and may remain latent after primary infection with a possibility of periodical reactivation EBV infection is transmitted by intimate, oral contact with previously infected persons, persons sick or infected earlier which secrete virus periodically. We report on pathogenesis of primary infection as well as clinical characteristics of infective mononucleosis and other EBV associated diseases (Birkitt lymphoma, nasopharyngeal carcinoma, syndrome of chronical fatigue).
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PMID:[The role of Epstein-Barr virus infections in human pathology]. 747 96

Within the clinical spectrum of erythema multiforme, two subgroups have been recently identified: recurrent erythema multiforme and the rare persistent erythema multiforme. Two additional cases of persistent erythema multiforme are described. Lesions were widespread and resistant to traditional therapies. One of the patients had an underlying malignancy; the other exhibited a symptom complex characterized by fatigue, fever, sore throat and lymphadenopathy, and an abnormal Epstein-Barr virus serologic profile suggestive of endogenous reactivation of Epstein-Barr virus infection.
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PMID:Persistent erythema multiforme: report of two new cases and review of literature. 761 87

CFIDS (chronic fatigue and immune disfunction syndrome) is also known as CFS (chronic fatigue syndrome), CEBV (chronic Epstein-Barr virus), M.E. (myalgic encephalomyelitis), yuppie flu and by other names. It is a complex illness characterized by incapacitating fatigue (experienced as exhaustion and extremely poor stamina), neurological problems and a constellation of symptoms that can resemble many disorders, including; mononucleosis, multiple sclerosis, fibromyalgia, AIDS-related complex (ARC) and autoimmune diseases such as lupus. These symptoms tend to wax and wane, but any often severely debilitating and may last for many months or years. All sections of the population (including children) are at risk, but women under 45 seem to be most susceptible. The investigators suggest that CFIDS results from dysfunction of the immune system. The exact nature of this dysfunction is not yet well defined, but it can generally be viewed as an unregulated or overactive state which is responsible for most of the symptoms. There is also evidence of some immune suppression in CFIDS. None of the treatments is consistently satisfactory, but some may be helpful: psychotherapy, physiotherapy, exercise programs, acupunctures, small doses of antidepressants, etc.
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PMID:[The chronic fatigue syndrome]. 790 Apr 53

Fibromyalgia (FM) is a very frequent syndrome of unknown cause, characterized by generalized pain, fatigue and a number of tender points to palpation. Among the several etiopathogenic hypotheses discussed, the association of FM with some viral infections has been the object of multiple studies due to its relation and similarity with the chronic fatigue syndrome, acknowledges as being related, although not exclusively, with the chronic infection by the Epstein-Barr virus. Many individual descriptions of association between infection with the human parvovirus B19 and FM led us to carry out this study, comparing the serology for that virus in 52 patients with FM and 39 healthy controls. The titers of specific IgG anti-parvovirus B19 antibodies, indicating previous infection with that virus, were determined in all 91 individuals through ELISA method and at the same laboratory. Results revealed, though not significantly, a greater prevalence of positive titers, of which the mean was also higher, in patients than in controls. When comparing the women from both groups, this tendency was even less perceptible. These data imply that there is no etiologic association between infection with the human parvovirus B19 and FM.
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PMID:[Viral infection and fibromyalgia]. 794 34


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