Chronic Fatigue Syndrome renamed with new diagnostic criteria

Following a thorough examination of the evidence base The Institute of Medicine (IOM) has proclaimed that chronic fatigue syndrome (CFS) a real disease and deserves the more accurate name of systemic exertion intolerance disease (SEID).

Between 836,000 and 2.5 million Americans suffer from myalgic encephalomyelitis/chronic fatigue syndrome—commonly referred to as ME/ CFS. This disease is characterized by profound fatigue, cognitive dysfunction, sleep abnormalities, autonomic manifestations, pain, and other symptoms that are made worse by exertion of any sort. ME/CFS can severely impair patients’ ability to conduct their normal lives.

The IOM convened an expert committee to examine the evidence base for ME/CFS.  In the resulting  282-page document titled Beyond Myal­gic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness, an IOM panel reports on its efforts to evaluate current clinical diagnostic criteria and develop new criteria for CFS, consider possible changes to terminology, and suggest a strategy for dissemination of the report’s conclusions. The 15-member panel that authored the report tackled that charge through extensive literature reviews, testimonies and reports in public hearings, and public comments.

The primary message of this report is that CFS is a serious, chronic, complex, multisystem disease that frequently and dramatically limits the activities of the affected patients. It is real and it is not appropriate to dismiss these patients by saying ‘I am chronically fatigued, too.’

The report establishes a new definition for the renamed SEID noting five main symptoms.   they also propose new diagnostic criteria.

Diagnosis requires that the patient have the following three symptoms:

  1. A substantial reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities, that persists for more than 6 months and is accompanied by fatigue, which is often profound, is of new or definite onset (not lifelong), is not the result of ongoing excessive exertion, and is not substantially alleviated by rest, and
  2. Post-exertional malaise,
  3. Unrefreshing sleep.

At least one of the two following manifestations is also required:

  1. Cognitive impairment
  2. Orthostatic intolerance

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