From Archives of Diseases in Childhood, 30 May 2012
Co-morbid conditions in children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) – a retrospective case note review of a large cohort
LM Oliver(1), K Patel(2)
(1) Brighton and Sussex Medical School, Brighton and Sussex University Hospitals (BSUH), Brighton, UK
(2) Royal Alexandra Children’s Hospital, Brighton and Sussex University Hospitals (BSUH), Brighton, UK
AIMS: CFS/ME is a complex illness, causing severe incapacitating fatigue, physical and cognitive complaints and is as disabling as many other serious chronic conditions. The prevalence in children is estimated to be 0.2-0.5%. The aim of this study was to take a cohort of children and adolescents with the condition and determine the pattern of co-morbid conditions.
METHODS: Our study took the form of a quantitative and semi-qualitative analysis undertaken as a retrospective case note review of a cohort of 131 patients attending a hospital based, consultant-led specialist CFS/ME clinic. Patients must have been diagnosed with CFS/ME using NICE and RCPCH criteria whilst under the care of a consultant paediatrician to be eligible to be included in the study. Information gathered from their hospital notes included basic demographics, CFS/ME diagnosis information and any co-morbid conditions present.
RESULTS; 80% of patients were female which was as expected, with CFS/ME acknowledged to be a female dominated disease. The median age at diagnosis of CFS/ME was 14 years, and there were a total of 38 different symptoms recorded at diagnosis. Other than fatigue, the most common symptoms were headaches, abdominal pain, musculoskeletal pain and decreased concentration and short term memory.
56% of the cohort had at least 1 co-morbid condition. There were 51 separate co-morbid conditions, with the most common conditions being psychiatric, gastrointestinal, respiratory and musculoskeletal problems. 30% of the patients had at least 1 co-morbid condition that the RCPCH lists as a differential diagnosis of CFS/ME.
CONCLUSION: This is the first study exploring co-morbid conditions in children and adolescents with CFS/ME. More than half of the cohort had at least one co-morbid condition. We wish to highlight to paediatricians that the presence of a co-morbid differential diagnosis does not appear to exclude CFS/ME.