f Post graduate mcqs and discussion : CHRONIC FATIGUE SYNDROME

Thursday, April 5

CHRONIC FATIGUE SYNDROME


It is applied to a state of easy fatigability accompanied by mild to moderate severe (debilitating) somatic symptoms.


Etiopathogenesis


Most pediatric subjects are adolescents, from both sexes with predominance of girls. The probable cause is an infection with replication of a known or new virus, including EBV, influenza virus, varicella, rubella as the inciting factor or nonspecific symptoms of a sore throat, fever, myalgia, diarrhea, etc.


Clinical Features


Chronic fatigue, varying from mild (subtle) to severe (debilitating) is the most predominant manifestation. This is often accompanied by deterioration in work or school performance, activities of daily living, exercise tolerance and interpersonal relationship. There may be a multitude of psychologic or neuropsychiatric complaints. Physical examination hardly shows any abnormal findings.


Diagnosis


It is primarily by exclusion. It is important to have a psychologic evaluation for depression or anxiety. A complete blood count  with ESR, electrolytes, Blood urea Nitrogen , creatinine, serum alanine transaminase and aspirate transaminase, thyroid function test and urinalysis and stool microscopy are in order to exclude treatable diseases and to reassure the patient.



Treatment


Therapy of Chronic Fatigue Syndrome  is directed towards emotional support for the child and his parents/family and symptomatic measures.


Prognosis

Complete Blood Count  is an illness of a prolonged duration with waxing and waning of symptoms. There is no mortality though significant morbidity is a rule.