Puzzling malaise: Unlocking the clues

With no definitive diagnosis or treatment, physicians and their patients look to researchers for some answers to chronic fatigue syndrome.

By Susan J. Landers, AMNews staff. July 23, 2001.

Christine Petty, MD, a family physician in Rockford, Ill., treated a patient for an illness that lasted six years. During that time, the man, then in his 40s, became so disabled he couldn't leave his home. He took a leave of absence from his job. His wife divorced him. Although his condition ultimately improved, his life was nearly destroyed.

Dr. Petty's patient had chronic fatigue syndrome, an illness that is often as devastating as it is puzzling and one for which there are more questions than answers.

Estimates of those with the illness have reached 800,000 in this country alone, according to recent research. But pinpointing its exact symptoms can be as perplexing as CFS itself.

Fatigue is a common complaint. But in the case of this patient, Dr. Petty could pick up signs that his difficulties were different. This patient's fatigue was both bone-crushing and unexplained. He also complained for at least six months of a host of other ills: low-grade fever, muscle aches, sore throat and sleep problems.

While there is a definition for CFS that was developed in 1994 and used by Dr. Petty in her diagnosis, most researchers and clinicians find it flawed. A new one is in the works. It is expected to be ready by 2003.

There is no definitive way to identify CFS. "It's mainly a diagnosis of exclusion," said Dr. Petty. Physicians must first rule out viral causes and cancer. So blood work and a thorough physical exam and good medical history are the first steps to take, she explained.

The Centers for Disease Control and Prevention recommends a series of about 15 tests physicians can use to screen for CFS. They include a complete blood count, measures of total protein in blood plasma as well as glucose levels. [...]