A follow-up
to this:
Chronic fatigue syndrome following infections in adolescents
Katz BZ, Jason LA.
Abstract
PURPOSE OF REVIEW:
To review the recent epidemiology, pathophysiology, and treatment of postinfectious chronic fatigue syndrome (CFS) in adolescents.
RECENT FINDINGS:
Thirteen percent of adolescents (mainly women) met the criteria for CFS 6 months following infectious mononucleosis; the figure was 7% at 12 months and 4% at 24 months.
Peak work capacity, activity level, orthostatic intolerance, salivary cortisol, and natural killer cell number and function were similar between adolescents with CFS following infectious mononucleosis and recovered controls.
Autonomic system, oxygen consumption, peak oxygen pulse, psychological and cytokine network differences were documented between those who recovered and those who did not.
SUMMARY:
The prognosis of CFS is better in adolescents than in adults.
Activity level, exercise tolerance, and orthostatic testing could not distinguish patients with CFS from adolescents who have recovered from infectious mononucleosis (controls), while certain cytokine network analyses, life stress factors, and autonomic symptoms could.
Via Adrienne Dellwo
… Looking at post-mono adolescents, researchers found it was mainly the girls who continued to have symptoms long term.
Many of those who fit the ME/CFS diagnostic criteria early on no longer did at follow up.
Here's at look at how the length of time post-infection effected the diagnostic rate:
6 months: 13%
12 months: 7%
24 months: 4%
Researchers say the following factors distinguished those with ME/CFS from kids who'd fully recovered:
- Certain cytokine network test results
- Oxygen consumption, at rest and during exercise
- Life stress factors (such as those caused by long-term illness)
- Symptoms of autonomic nervous system dysfunction
They did not find significant differences in activity level, exercise tolerance or orthostatic testing.
…
CFIDS in 2009: Post-Mono CFS in Teen Girls
Ben Z. Katz, M.D., of Northwestern University has just published results from a study of teens who were followed for two years after the onset of acute infection with Epstein-Barr virus (mononucleosis). The article is published in the July 2009 issue of Pediatrics. Criteria for CFS were met by 13 percent of adolescents at 6 months after acute infection. Seven percent remained ill at 12 months, and 4 percent met CFS criteria at 24 months. With time, most adolescents recovered. Only 2 adolescents with CFS at 24 months seemed to have recovered or had an explanation for CFS at 12 months, but then were reclassified as having CFS at 24 months.
All 13 adolescents who had CFS 24 months after onset of mononucleosis were girls. Compared with those who did not have CFS at 24 months, they reported greater fatigue severity at 12 months. Corticosteroid treatment during the acute phase of mononucleosis was not associated with an increased risk for the development of CFS.
This study was funded by NIH and its principal investigator is Renee Taylor, PhD, at University of Illinois-Chicago. Dr. Katz and Dr. Taylor are also collaborating with Association-funded researcher Gordon Broderick, PhD, who is studying the same patient group to understand differences between those who recovered from mono and those who remained ill at various time points. Read more about the Association's study at http://www.cfids.org/cfidslink/2009/030402.pdf.
An article about the study was circulated by Reuters and can be read at http://www.vancouversun.com/health/Mono+linked+chronic+fatigue+syndrome+teens/1817020/story.html.
Medscape News also reported on the publication at http://www.medscape.com/viewarticle/705653. You can also find continuing education courses about CFS on Medscape to share with your healthcare professional, including the one sponsored by the CFIDS Association of America that has attracted more than 243,000 page views since it went live in October 2008. The CFS course is located at http://cme.medscape.com/viewprogram/17442.
Journal citation: “Chronic fatigue syndrome after infectious mononucleosis in adolescents.” Katz BZ, Shiraishi Y, Mears CJ, Binns HJ, Taylor R. Department of Pediatrics, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital, Chicago, Illinois 60614, USA. Pediatrics. 2009 Jul;124(1):189-93.