http://www.ncbi.nlm.nih.gov/pubmed/27344315
Though this is a study on idiopathic gastroparesis it looks like half the patients had an ME/CfS diagnosis (I included the relevant passage below the abstract).
Though this is a study on idiopathic gastroparesis it looks like half the patients had an ME/CfS diagnosis (I included the relevant passage below the abstract).
Dig Dis Sci. 2016 Jun 25. [Epub ahead of print]
Gastric Enterovirus Infection: A Possible Causative Etiology of Gastroparesis.
Barkin JA1, Czul F2, Barkin JS2, Klimas NG3, Rey IR3, Moshiree B2.
Author information
Abstract
BACKGROUND:
Gastroparesis (GP) is a disabling chronic gastroenterologic disorder with high morbidity that severely impacts patients' quality of life. GP can present acutely after a viral-like gastrointestinal illness resulting in speculation that in some patients, neurologic damage caused by the infection might underlie the pathogenesis of idiopathic gastroparesis (IGP).
AIMS:
The aim of this study is to document case reports of Enterovirus (EV) infection as a possible cause of IGP.
METHODS:
Eleven patients referred with a diagnosis of GP underwent workup to exclude known causes of GP. Those with a history of flu-like symptoms or gastroenteritis prior to onset of GP symptoms had gastric biopsies taken during upper endoscopy to assess for the presence of gastric mucosal EV infection. Data on presenting symptoms, extra-intestinal symptoms and conditions, prior nutritional support requirements, upper endoscopy findings, and response to therapy were cataloged.
RESULTS:
Eleven patients were diagnosed as IGP. Nine had active EV infection on gastric biopsies and were included (7/9 female, mean age 43 years). Eight out of nine received EV treatment with antivirals and/or immune therapies, with a wide degree of variability in treatment regimens. Four out of eight who received EV treatment had symptomatic improvement. One patient had stable symptoms. Three patients are currently undergoing therapy.
CONCLUSIONS:
Gastric EV infection was frequently detected (82 %) in patients undergoing investigation for IGP. Antiviral and/or immune therapies against EV seem to be favorable, as most of our patients had resolution of their GP symptoms after treatment. This is the first study to identify EV as a possible infectious etiology of IGP.
KEYWORDS:
Enterovirus; Gastroparesis; Idiopathic; Infection
PMID:
27344315
DOI:
10.1007/s10620-016-4227-x
Results
Eleven patients were diagnosed as IGP and, based on history of prior infection preceding the onset of their symptoms, underwent further testing for gastric EV infection. Nine (82 %) were found to have active EV infection on gastric biopsies (with positive staining of gastric mucosa), and those were the patients subsequently included in the study. Seven (78 %) were female with a mean age of 43 years (Table 1). Heartburn was the most common upper GI symptom in 67 % of patients followed by nausea/ vomiting (44 %), and constipation was the most commonly reported lower GI symptom in 56 %. Seven (78 %) patients had extra-intestinal symptoms and conditions associated with their IGP, such as autonomic dysfunction confirmed by tilt table testing (56 %), and myalgic encephalomyelitis/chronic fatigue syndrome (56 %). Three (33 %) patients required total parenteral nutrition, and two (22 %) required gastric pacemaker placement.
On upper endoscopy, 78 % of patients had endoscopic findings of mucosal erythema and edema described as gastropathy. Of the nine included patients with gastric biopsies positive for EV, eight (89 %) received EV treatment with antivirals and/or immune therapies, with a wide degree of variability in treatment regimens (Table 2). One patient elected not to undergo treatment for EV infection as they had a marked response to domperidone therapy with control of their symptoms.