ME/CFS in the Department of Medicine

Diagnosis

Before considering the possibility that a patient may have infection-associated CFS, the patient would need to have experienced fatigue for at least six months, and the patient's primary care provider would need to rule out the following categories of diseases as possible causes of the patient’s fatigue. We have listed some examples of common diseases to rule out in each category.

Autoimmune diseases
Dermatomyositis
Lupus erythematosis
Reiter’s syndrome
Rheumatoid arthritis
Sarcoidosis
Sjongren’s syndrome
Vasculitis
Endocrine diseases
Addison’s disease
Diabetes mellitus
Hyperthyroidism
Hypothyroidism
Ovarian failure
Panhypopituitarism
Gastrointestinal diseases
Celiac disease
Crohn’s disease
Irritable bowel syndrome
Ulcerative colitis
Neuromuscular diseases
Muscular dystrophies
Multiple sclerosis
Myasthenia gravis
Psychiatric diseases
Alcohol/drug abuse
Anxiety disorder
Depression
Hyperventilation syndrome
Manic-depressive illness
Schizophrenia
Other diseases
Dysautonomias
Narcolepsy
Sleep apnea
New or recurring cancer

The following tests may be useful to the patient’s physician to rule out other causes of fatigue:

If the CBC is abnormal, a ferritin test may be appropriate.

If there are objective clinical manifestations that may suggest an autoimmune disease, such as very low WBC or platelet count, evidence of renal disease, swelling of the joints, or specific rashes, an ANA and rheumatoid factor test may be appropriate.

If all of the preceding diseases have been ruled out, all tests appear normal, and fatigue has been present for more than 6 months, it is then possible that the patient and physician may want to consider the possibility that a chronic infection may be contributing to the fatigue.

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