Our weekly roundup of research abstracts that have not already appeared on the MEA website.
Clin Exp Obstet Gynecol. 2011;38(4):412-3.
Sympathetic neural hyperalgesia edema syndrome, a frequent cause of pelvic pain in women, mistaken for Lyme disease with chronic fatigue.
Check JH, Cohen R.
The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA. firstname.lastname@example.org
PURPOSE: To show that chronic fatigue syndrome can be mistakenly attributed to Lyme disease rather than considering sympathetic neural hyperalgesia edema syndrome. This common disorder of women, frequently, but not always causing pelvic pain, can present simply as chronic fatigue.
METHODS: A water load test was performed in a woman reactive for B-Burgdorferi with chronic fatigue whose symptoms did not improve despite three months of treatment with doxycycline. A water load test was performed.
RESULTS: She failed the water load test by excreting only 50% ingested load standing for four hours. She showed marked improvement following treatment with dextroamphetamine sulfate.
CONCLUSIONS: This very treatable disorder of the sympathetic nervous system should be considered in women with an unknown cause of chronic fatigue or if the symptoms persist despite treatment of another potential cause.
Trends Microbiol. 2011 Nov;19(11):525-9. Epub 2011 Oct 4.
Xenotropic murine leukaemia virus-related virus (XMRV) does not cause chronic fatigue.
Robinson MJ, Erlwein O, McClure MO.
Section of Infectious Diseases, Jefferiss Research Trust Laboratories, Imperial College London, St Mary’s Campus, London, W2 1PG, UK.
The xenotropic murine leukaemia virus-related virus (XMRV), a gammaretrovirus, was discovered in prostate cancer tumours by Virochip technology in 2006. It was subsequently detected in chronic fatigue patients in 2009. The association between XMRV and chronic fatigue has proved to be controversial. No study has confirmed these findings and many have refuted them. Here, we present the evidence for our contention that XMRV is not a human pathogen.
Fam Pract. 2011 Oct;28(5):572-8. Epub 2011 May 9.
Patients’ hopes and expectations of a specialist chronic fatigue syndrome/ME service: a qualitative study.
McDermott C, Lynch J, Leydon GM.
Primary Medical Care Research Department, University of Southampton, Southampton, UK. email@example.com
BACKGROUND: The 2007 National Institute for Health and Clinical Excellence guidelines on Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) recommend early management of the condition. Investment by the Department of Health has expanded the number of specialist U.K. CFS/ME services but there has been little research on what patients hope or expect from referral.
METHODS: A qualitative study exploring hopes and expectations of patients newly referred to a CFS/ME Service in the South of England. Interviews with 20 patients were analysed using the constant comparative method.
RESULTS: Participants hoped referral to a specialist service would clarify diagnosis, give guidance and support, assist in understanding the complexity of the illness and provide hope for the future. While many participants valued the support of their GP, all viewed referral as offering a level of specialist expertise beyond that available in primary care. Many participants expressed high levels of uncertainty about the nature of CFS/ME. While participants hoped that the service would be able to provide information and guidance, many expressed the view that more information earlier in their illness would make the waiting period less stressful and make it possible for them to do more to help themselves.
CONCLUSIONS: GP referral to a specialist service appeared to be highly valued by the participants in this study. The levels of uncertainty expressed by many patients about the nature of CFS/ME raises the issue of the role of information on CFS/ME during the early stages of the illness and suggests a need for more reassurance and positive advice during the waiting period.
J Clin Immunol. 2011 Aug;31(4):584-7. Epub 2011 Apr 21
Xenotropic murine leukemia virus- related virus (XMRV) in patients with systemic lupus erythematosus.
Balada E, Castro-Marrero J, Felip L, Vilardell-Tarrés M, Ordi-Ros J.
Research Unit in Systemic Autoimmune Diseases, Vall d’Hebron Research Institute, Vall d’Hebron Hospital, Autonomous University of Barcelona, Barcelona, Spain. firstname.lastname@example.org
OBJECTIVES: Xenotropic murine leukemia virus-related virus (XMRV)-specific proviral DNA has been recently detected in peripheral blood mononuclear cells of patients with chronic fatigue syndrome. Since chronic fatigue is commonly reported in patients with systemic lupus erythematosus (SLE) we aimed at testing the presence of this virus in these patients.
METHODS: Ninety-five SLE patients, 45 of whom had a Fatigue Severity Scale score higher than 3, were included. Molecular analyses were performed by PCR from DNA obtained from the whole blood of both SLE patients and 50 healthy controls.
RESULTS: None of the 145 samples analyzed yielded the specific XMRV PCR product.
CONCLUSIONS: We conclude that XMRV is not detected in blood neither from SLE patients nor from healthy controls. It leads to infer that other environmental and biological triggers (different from XMRV) may account for the increased levels of fatigue over the course of SLE.