Re:Will adopting the Canadian criteria improve the diagnosis of chronic fatigue syndrome?
Dr Crawley writes:
" More worrying is that "symptoms", such as ataxia, "palpitations
with cardiac arrhythmias", and "loss of thermostatic stability" count
towards the diagnosis, rather than suggesting alternative diagnoses."
Whilst of course these symptoms could suggest an alternative
diagnosis to CFS/ME, she seems to be discounting the research by Prof
Julia Newton and colleagues at Newcastle which shows that 27% of patients
diagnosed with CFS/ME also have postural orthostatic tachycardia syndrome,
which is a form of dysautonomia.
Patients with this syndrome experience not only an increase in heart
rate on being upright, but a whole host of other symptoms including
problems regulating body temperature, palpitations, digestive and bladder
problems, balance problems, and many other symptoms which are associated
with dysfunction of the autonomic nervous system.
CFS/ME patients seem to fit into different subgroups, and in at least
one group, autonomic dysfunction is a key part of the illness. Personally,
I have been diagnosed with POTS by a cardiologist who says he finds it
very hard to distinguish between the two conditions as there is so much
overlap. I have also been told by an immunologist and a neurologist (both
mainstream NHS clinicians) that CFS/ME is a form of autonomic dysfunction,
amongst other things.
All this comes back to the need to elucidate the different subgroups
of those diagnosed under the CFS umbrella, if research is ever going to
progress in a meaningful way.
Rapid Response:
Re:Will adopting the Canadian criteria improve the diagnosis of chronic fatigue syndrome?
Dr Crawley writes:
" More worrying is that "symptoms", such as ataxia, "palpitations
with cardiac arrhythmias", and "loss of thermostatic stability" count
towards the diagnosis, rather than suggesting alternative diagnoses."
Whilst of course these symptoms could suggest an alternative
diagnosis to CFS/ME, she seems to be discounting the research by Prof
Julia Newton and colleagues at Newcastle which shows that 27% of patients
diagnosed with CFS/ME also have postural orthostatic tachycardia syndrome,
which is a form of dysautonomia.
Patients with this syndrome experience not only an increase in heart
rate on being upright, but a whole host of other symptoms including
problems regulating body temperature, palpitations, digestive and bladder
problems, balance problems, and many other symptoms which are associated
with dysfunction of the autonomic nervous system.
CFS/ME patients seem to fit into different subgroups, and in at least
one group, autonomic dysfunction is a key part of the illness. Personally,
I have been diagnosed with POTS by a cardiologist who says he finds it
very hard to distinguish between the two conditions as there is so much
overlap. I have also been told by an immunologist and a neurologist (both
mainstream NHS clinicians) that CFS/ME is a form of autonomic dysfunction,
amongst other things.
All this comes back to the need to elucidate the different subgroups
of those diagnosed under the CFS umbrella, if research is ever going to
progress in a meaningful way.
Competing interests: No competing interests