Is chronic fatigue syndrome (CFS/ME) heritable in children, and if so, why does it matter?

University of Bristol, Bristol, England, United Kingdom
Archives of Disease in Childhood (Impact Factor: 2.9). 01/2008; 92(12):1058-61. DOI: 10.1136/adc.2006.110502
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Available from: Esther Crawley, Nov 19, 2015
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    • "Although an infection of the central nervous system (CNS) would seem likely, the lack of affirmative findings has led to a preference for other theories, including: psychological stress, disturbances of immunity, endocrine control, oxidative stress, cardiovascular homeostasis, and systemic infections. Not surprisingly, genetic constitution also appears to be important [5] [6]. A majority of cases report that the onset of CFS was preceded by a ''flu-like'' illness. "
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    ABSTRACT: Chronic fatigue syndrome (CFS) is a disabling disease of unknown aetiology. A variety of factors have been suggested as possible causes. Although the symptoms and clinical findings are heterogeneous, the syndrome is sufficiently distinct, at least in relation to the more obvious cases, that a common explanation seems likely. In this paper, it is proposed that the disease is caused by a ubiquitous, but normally benign virus, e.g., one of the circoviruses. Circoviruses are chronically present in a majority of people, but are rarely tested for diagnostically. Normally these viruses do not penetrate the blood-brain barrier, but exceptions have been reported, and related viruses cause disease in the central nervous system of animals. The flu-like illness that often precedes the onset of CFS may either suppress immune function, causing an increased viremia, and/or lower the blood-brain barrier. In both cases the result may be that a virus already present in the blood enters the brain. It is well known that zoonotic viruses typically are more malignant than viruses with a long history of host-virus evolution. Similarly, a virus reaching an unfamiliar organ may cause particular problems.
    Medical Hypotheses 02/2008; 71(2):270-4. DOI:10.1016/j.mehy.2008.03.014 · 1.07 Impact Factor
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    ABSTRACT: To investigate factors associated with school attendance and physical function in paediatric chronic fatigue syndrome/myalgic encephalopathy (CFS/ME). Cross-sectional study. Regional specialist CFS/ME service. Children and young people aged under 18 years. Self-reported school attendance and physical function measured using the physical function subscale of the Short Form 36. Linear and logistic regression analysis of data from self-completed assessment forms on children attending a regional specialist service between 2004 and 2007. Analyses were done in two groups of children: with a completed Spence Children's Anxiety Scale (SCAS) and with a completed Hospital Anxiety and Depression Scale (HADS). Of 211 children with CFS/ME, 62% attended 40% of school or less. In children with completed SCAS, those with better physical function were more likely to attend school (adjusted odds ratio (OR) 1.70; 95% CI 1.36 to 2.13). This was also true for those with completed HADS (adjusted OR 2.05; 95% CI 1.4 to 3.01). Increasing fatigue and pain and low mood were associated with worse physical function. There was no evidence that anxiety, gender, age at assessment, family history of CFS/ME or time from onset of symptoms to assessment in clinic were associated with school attendance or physical function. Paediatricians should recognise that reduced school attendance is associated with reduced physical function rather than anxiety. Improving school attendance in children with CFS/ME should focus on evidence-based interventions to improve physical function, particularly concentrating on interventions that are likely to reduce pain and fatigue.
    Archives of Disease in Childhood 11/2008; 94(10):752-6. DOI:10.1136/adc.2008.143537 · 2.90 Impact Factor
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    ABSTRACT: Chronic fatigue syndrome/myalgic encephalopathy (CFS/ME) in children is a common condition associated with considerable controversy with reference to terminology, case definition, aetiology, treatment and prognosis. This frequently results in patients and families receiving mixed messages, and significant delay in establishing a diagnosis and receiving an appropriate management programme. We review current understanding and draw attention to the best practice approach to assessment, diagnosis and management of CFS/ME in children. This, we hope, will improve planning, organization and delivery of a patient-centred, optimized and clinically-effective multidisciplinary management strategy towards children with CFS/ME.
    Paediatrics and Child Health 02/2009; 19(2-19):84-89. DOI:10.1016/j.paed.2008.11.001
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