[Haworth co-indexing entry note]: Clinical and Pathogenetical Characterization of 238 Patients of a
Chronic Fatigue Syndrome ItalianCenter. Racciatti,Delia et al.Co-published simultaneously in Journal of
Chronic Fatigue Syndrome (The HaworthMedical Press, an imprint of The Haworth Press, Inc.) Vol. 5,
No. 3/4, 1999, pp. 61-70; and: Chronic Fatigue Syndrome: Advances in Epidemiologic, Clinical, and Basic
Science Research (ed: Roberto Patarca-Montero) The Haworth Medical Press, an imprint of The Haworth
Press, Inc., 1999, pp. 61-70.
SUMMARY. Prolonged fatigue is a common complaint in the community
and is usually transitory. If fatigue continues for more than six
months, is disabling, and is accompanied by other constitutional and
neuropsychiatric symptoms, then a diagnosis of chronic fatigue syndrome
(CFS) should be considered.
CFS probably is an heterogeneous disease, maybe multifactorial, or
it includes different pathologies which manifest with the same symptoms.
In some cases, the mode of presentation of the illness implicate
the exposure to chemical and/or food toxins as precipitating factors
(e.g., ciguatera poisoning, Gulf War Syndrome, etc.). In other CFS
cases, the etiology is still unknown: there are various hypotheses on
pathogenetic events which, alone or in association with each other, may
precipitate the illness. In fact, it is probable an involvement of multiple
events in CFS onset where different precipitating factors can interact
each other, even if not always all present in the single patient: latent
and/or chronic viral infections, immunologic and neuroendocrine dysfunctions,
psychological, environmental and mood factors.
In accordance to this theory, we consider various subgroups of CFS
patients on the basis of the pathway and the mode of presentation of the
disease. The Clinic of Infectious Diseases of G. DAnnunzio University
of Chieti is one of the main National Reference Centers for the
CFS Study in Italy. From January 1992 to January 1998, 238 patients
came to our observation: 89 of them met CDC criteria for CFS (1994),
127 did not; the other 22 patients are still under evaluation. Our patients
underwent physical examination (including tests for searching for the
possible coexistence of a fibromyalgia syndrome), psychiatric interview
with several neuropsychological tests, laboratory tests (including magnesium
determination on serum), neuroendocrine evaluation (circadian
rhythm of several hormones, buspirone challenge test), SPECT scans to
evaluate cerebral perfusion, and other examinations where necessary in
according to the symptomatology of each patient (e.g., orthopedic,
ORL, EMG, muscle biopsy, etc.).
According to our preliminary results, we subdivided our patients in
different subgroups and we studied them comparatively.
We report the more significant data collected from this evaluation
that might lead to a better understanding of the syndrome and in particular
of its pathways course, a knowledge that will help in choosing
appropriate therapies for each subgroups.
