Chronic Fatigue Syndrome

April 29, 2015

A recent report from the Institute of Medicine (IOM) suggests new diagnostic criteria and a new name for this disease:  Systemic Exertional Intolerance Disease.  Why? The IOM indicates that the term “chronic fatigue syndrome” can result in stigmatization and trivialization and should not longer be the name of this illness.  Key messages in report include the fact that CFS is a serious, chronic, complex, multi-system disease that can profoundly limit the health and physical activities of affected patients.  and that a thorough history, physical exam and work-up are necessary to determine an appropriate diagnosis.

Proposed diagnostic criteria requires three symptoms:

1.  a substantial reduction/impairment in the ability to engage in pre-illness levels of occupational, educational, social or personal activities that persists for more than six months and is accompanied by fatigue, often profound and is of new or definite onset (not lifelong) and is not the result of excessive exertion, and is not substantially alleviated by rest;

2.  post-exertional malaise; and

3.  unrefreshing sleep.

Additionally, at least one of the following manifestations is required:

1.  cognitive impairment

2.  orthostatic intolerance

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