chronic fatigue syndrome

(redirected from Minor criteria)
Also found in: Dictionary, Medical.

chronic fatigue syndrome

(CFS), collection of persistent, debilitating symptoms, the most notable of which is severe, lasting fatigue. In other countries it is known variously as myalgic encephalomyelitis (ME), chronic fatigue and immune dysfunction syndrome, and postviral fatigue syndrome. It may have been first recognized as a syndrome in the 1860s by George Beard, who used the term neurasthenianeurasthenia
, condition characterized by general lassitude, irritability, lack of concentration, worry, and hypochondria. The term was introduced into psychiatry in 1869 by George M. Beard, an American neurologist; he believed it to be a neurosis with a fatigue component.
..... Click the link for more information.
 to described what he believed to be a neurosis with a fatigue component. Definitions and theories of its cause have changed over the years; many cases have been misdiagnosed as imaginary because doctors could find no cause. In the mid-1980s it came to the public's attention, as affluent women in their thirties began to seek treatment. (For unknown reasons, more women than men seek treatment for the disease.)

Symptoms and Identification

As currently defined, chronic fatigue syndrome is the presence of severe, disabling fatigue lasting for six or more consecutive months. The fatigue is persistent or relapsing, and is new (i.e., not lifelong), not relieved by rest, not the result of ongoing exertion, and interferes with normal work, social, educational, or personal activities. Diagnosis also requires at least four of the following symptoms, each persistent or recurring and not present before the fatigue: impairment of short-term memory or concentration, sore throat, tender lymph nodes in the neck or axillary region, muscle pain, joint pain, headaches peculiar to the syndrome, unrefreshing sleep, and malaise of more than one day's duration following exertion. Chronic fatigue that does not meet all these criteria is termed "idiopathic fatigue."

The course of the disease varies. Many people first experience symptoms after a cold or bout of the flu. Most people reach a plateau early on; the symptoms come and go with varying severity afterward. Some experience complete remission; others have their symptoms indefinitely.

There are no specific diagnostic tests. Diagnosis must first rule out known causes of fatigue such as hypothyroidism, cancer, multiple sclerosis, and major depression with psychotic or melancholic features (e.g., schizophrenia, bipolar disorder). Chronic fatigue syndrome and nonpsychotic, nonmelancholic depression, however, are not mutually exclusive. Substance abuse and side effects of prescribed medications must also be eliminated as possible causes.

Cause and Treatment

There is no known single cause of CFS. Some authorities believe it is a condition shared by many different underlying diseases rather than an entity unto itself; others believe it is caused by a defect of the immune system. Hormonal deficits, low blood pressure, and viral infections have been studied as possible causes or contributors. The postulated causal link with Epstein-Barr virusEpstein-Barr virus
(EBV), herpesvirus that is the major cause of infectious mononucleosis and is associated with a number of cancers, particularly lymphomas in immunosuppressed persons, including persons with AIDS.
..... Click the link for more information.
 hypothesized in the mid-1980s has been discounted. In 2009 researchers announced that they had found xenotropic murine-leukemia-virus-related virus (XMRV) in many patients with CFS, but the study did not show that XMRV was linked to CFS. Other studies failed to replicate its findings, and the paper was later retracted.

There is no definitive treatment for CFS, although success has been reported anecdotally with antidepressants, antianxiety medications, antivirals, and immune boosters. Symptomatic treatment for the muscle and joint pains is helpful in some cases, as are psychological and physical therapies. Counseling and peer support groups may help some patients cope with the frustrating nature of the disease. A British study reported in 2012 that cognitive behavioral therapy and graded exercise therapy were the most successful and cost-effective treatments, but other have asserted that that assessment significantly overstating the results of the study.

References in periodicals archive ?
3243 Purulent nasal discharge 0 0 N/A Minor criteria Flyposmia 9 (42.
A diagnosis of definite tricuspid valve IE was made based on the modified Duke criteria with one major (oscillating valve mass) and four minor criteria (IDU, suspected septic pulmonary infarcts, fever and a typical micro-organism (Staphylococcus aureus) on one blood culture).
World Health Organization Diagnostic Criteria for Systemic Mastocytosis Major criterion Multifocal compact infiltrates of mast cells (>15) in extracutaneous organ(s) Minor criteria 1.
Major criteria * Violet edges of the inflammatory lesion * Exclusion of relevant differential diagnoses (venous and arterial ulcers, vasculitis) Minor criteria * Histological examination showing neutrophilic infiltration of the dermis * Immunoglobulin or complement or both of the storage * The presence of an associated disease * Partial response or no response to conventional therapy * Response to immunosuppressive treatment
Family * ARVC/D confirmed in a first-degree history relative who meets current task force criteria * ARVC/D confirmed pathologically at autopsy or surgery in a first-degree relative * Identification of a pathogenic mutation categorized as associated or probably associated with ARVC in the patient under evaluation Category Minor criteria I.
When findings are negative for this mutation, the patient should undergo analysis for the JAK2 exon 12 mutation, and the minor criteria should be evaluated by means of bone marrow biopsy (5).
Task Force Criteria 2010 Revised Task Force criteria for the diagnosis of ARVC/D (1) Definite diagnosis: 2 major and 2 minor criteria or 4 minor from different categories Borderline: 1 major and 1 minor or 3 minor criteria from different categories Possible: 1 major or 2 minor criteria from different categories I.
Diagnosis requires the presence of both major criteria and one minor criterion or the first major criterion plus two minor criteria.
However, according to the American Thoracic Society and European Respiratory Society Consensus Statement, the diagnosis of IPF can be made without a surgical lung biopsy if the following major and minor criteria are met.
Cases were defined clinically as "definite" if they fulfilled two of the Duke major criteria, one major plus three minor criteria, or five minor criteria; they were defined as "possible" if they fulfilled one major plus one minor criteria, or three minor criteria.
Major and minor criteria have been proposed to standardize the diagnosis, resumed in table 1.
Adiagnosis can be made if a paitent has both of the major criteria, or if the patient fulfills one major criteria and two minor criteria, or simply has four minor criteria.