Een studie van Oliver en Patel onder CVS-patiënten levert opmerkelijke resultaten op:
- Een CVS-patiënt heeft gemiddeld 38 symptomen! bij de eerste diagnose.
- De meest voorkomende symptomen zijn: buikpijn, spierpijn, hoofdpijn
en cognitieve klachten (geheugen-/concentratieproblemen etc.).
- 56% van de patiënten had minstens één andere medische aandoening, met name
psychische problemen, maag-/darmproblemen, ademhalingsklachten en spierklachten.
- 30% van de CVS-patiënten maar voldeed ook aan de criteria van minstens één andere
medische aandoening die tot een andere (tweede!) diagnose zou kunnen leiden.
De conclusie: een andere medische diagnose sluit de diagnose CVS niet uit.
Dit laatste staat echter (deels) weer haaks op de eisen van de CVS-Fukuda-criteria,
hetgeen nog maar weer eens de grote tekortkomingen van die criteria onderstreept.
Co-morbid conditions in children with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) – a retrospective case note review of a large cohort.
Arch Dis Child 2012;97:A105 doi:10.1136/archdischild-2012-301885.248.
Oliver LM, Patel K.
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 diagnosisof 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.
http://adc.bmj.com/content/97/Suppl_1/A105.1.abstract
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