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Immune network analysis of cerebrospinal fluid in ME/CFS with atypical & classical presentations

Also confused/scientifically illiterate/worried. Are they saying that every patient that did not exhibit a classical viral onset (e.g. all gradual onset patients, like myself) are 'atypical' and thus predisposed to later comorbidities? The language in the Simmaron piece is vague.
I don't believe so.
Cort's article said:
This week, new findings were published by Columbia and Simmaron that define 2 subsets. They’re not the usual suspects (infectious trigger vs non-infectious trigger; gradual onset vs acute onset). In fact, they involve subsets few would have predicted a couple of years ago.
and
Cort's article said:
The atypical vs classical distinction was pre-established by Dr. Peterson before the analysis. Based on his wide-ranging clinical experience, the atypical group stood out for either: 1) the presence of unusual precursors (triggers) of ME/CFS or; 2) the development of more unusual and severe comorbidities over varying (and often long-term) intervals after ME/CFS onset.
So what they are calling the atypical group are patients whose ME started from less usual triggers and those who go on to develop other serious conditions. And my reading of that first quote seems to indicate that gradual onset wasn't used to identify anybody as atypical. My history is of gradual onset but I believe I can pinpoint the start of the process to a bad measles infection, so I believe I would count in their classic ME group.
 
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Thanks, I think/hope you're right. The confusion seems to stem from the fact that 'classical' is fairly clearly defined as viral-onset, so then it's tempting to assume everyone else is atypical, but that could easily not be the case

I don't believe so.

and

So what they are calling the atypical group are patients whose ME started from less usual triggers and those who go on to develop other serious conditions. And my reading of that first quote seems to indicate that gradual onset wasn't used to identify anybody as atypical. My history is of gradual onset but I believe I can pinpoint the start of the process to a bad measles infection, so I believe I would count in their classic ME group.
 

Forbin

Senior Member
Messages
966
To classify a patient as atypical ME because they subsequently developed cancer seems odd to me.

Have I missed something obvious?

Yeah, this does seem like it needs clarification. Nearly half of the US population that reaches age 65 will have developed non-melanoma skin cancer, for example. I doubt one would be classified "atypical" for that.
http://www.skincancer.org/skin-cancer-information/skin-cancer-facts

As I recall, Osler's Web did mention that there was a spike of lymphoma cases in Dr. Peterson's practice. They were few in number, but they were still out of proportion to the size of his practice.
 
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From reading the paper I think the best way to view it as "atypical" being anything different to the normal represented by "classical" ME, in the same way that you could separate the general population into classically healthy (no health issues) and atypically healthy (health issues of any sort). So "atypical" is very much a broad category and needs further investigation.

But I think we all need to keep in mind that this is an initial study, and Mady Hornig acknowledges that replication is very much needed.
 

RogerBlack

Senior Member
Messages
902
I have not read the initial paper, as I've been exhausted with mundane tasks.
What is the p value for the allegation of increased cancer et al from this study?
The diseases mentioned seem common ones.
 
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I think the main takeaway from this study is the evidence of different subsets in ME. I wouldn't get too bogged down in details at this point, as things are likely to develop as new cohorts are explored.
I think the question is, how does the evidence of subsets stack up and are these subsets really meaningful.

It might be premature to say we have evidence of subsets.
 

wastwater

Senior Member
Messages
1,270
Location
uk
If there was immune exhaustion after 3 years wouldn't you expect infections to start to reappear with more frequency.
This doesn't seem to happen in a lot of cases with those staying hyperimmune like myself