Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- fadiga incapacitante persistente
- mal-estar/fadiga pós-esforço (PEM), exaustão por esforço
- perda da memória de curto prazo e comprometimento de concentração
- faringite
- artralgia generalizada sem inflamação
- cefaleia/enxaqueca com início após a fadiga
- sono não revigorante
- intolerância ortostática
- dor difusa nos músculos, tendões, fáscias ou outro tipo de dor
- linfonodos sensíveis à palpação
Outros fatores diagnósticos
- idade de início (adolescência e dos 30 aos 50 anos)
- sintomas tipo gripe (mal-estar, mialgia, sensação de febre)
- tontura
- ansiedade, transtorno afetivo, depressão atípica
- sensações de temperatura alterada
- disfunção cognitiva induzida por esforço (afetando a memória de trabalho, não persistente)
- sensibilidade a substâncias irritantes
- sensação febril
Fatores de risco
- sexo feminino
- Infecção por Epstein-Barr em adolescentes
- história familiar positiva de SFC/EM
- fatores genéticos
- doenças infecciosas específicas em adultos
- autoimunidade
- microbioma intestinal
- fatores psicológicos
- transtorno depressivo maior
- ascendência
- hipermobilidade/frouxidão articular
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Questionário de sintomas DePaul
- hemograma completo com diferencial de leucócitos
- velocidade de hemossedimentação
- proteína C-reativa
- perfil metabólico completo
- hormônio estimulante da tireoide
- fator antinuclear (FAN), fator reumatoide
- exame de anticorpo anti-HIV (vírus da imunodeficiência humana)
Investigações a serem consideradas
- teste da mesa inclinável com a cabeça para cima em caso de intolerância ortostática sintomática
- ferritina sérica
- HbA1c
- exame toxicológico da urina
- testes de anticorpos para sensibilidade ao glúten/doença celíaca
Novos exames
- teste ergométrico de 2 dias
Algoritmo de tratamento
todos os pacientes
Colaboradores
Autores
James N. Baraniuk, MD

Professor
Division of Rheumatology, Immunology, and Allergy
Georgetown University
Washington
DC
Declarações
JNB declares that he has no competing interests.
Agradecimentos
Dr James N. Baraniuk would like to gratefully acknowledge Dr Craig N. Sawchuk and Dr Dedra Buchwald, previous contributors to this topic.
Declarações
CNS declares that he has no competing interests. DB is an author of a number of references cited in this topic. This topic was reviewed in 2018 by a patient with CFS/ME, and their feedback was considered as part of the topic update. The patient peer reviewer does not wish to be named.
Revisores
Alastair Santhouse, MA (Cantab), MB, B.Chir, FRCP, FRCPsych
Consultant Psychiatrist in Psychological Medicine
South London and Maudsley NHS Foundation Trust
Denmark Hill
London
UK
Declarações
AS declares that he was a guideline development group member for NICE CFS/ME 2007 guidelines CG53.
Ben Z. Katz, MD
Professor of Pediatrics
Division of Infectious Diseases
Northwestern University Feinberg School of Medicine
Attending Physician
Ann & Robert H. Lurie Children’s Hospital of Chicago
Chicago
IL
Declarações
BZK declares that he has no competing interests.
Indre Bileviciute-Ljungar, MD, PhD
Associated Professor in Rehabilitation Medicine
Department of Clinical Sciences
Danderyd University Hospital
Karolinska Institutet
Stockholm
Sweden
Declarações
IB-L declares that he has no competing interests.
Tarek Gaber, MB, BCh, MSc, FRCP
Consultant Physician in Rehabilitation Medicine
Wrightington, Wigan and Leigh NHS Trust
Leigh Infirmary
Leigh
UK
Declarações
TG declares that he has no competing interests.
Malcolm Hooper, PhD, B Pharm, MRIC, C Chem
ME patient advocate
Emeritus Professor of Medicinal Chemistry
University of Sunderland
Sunderland
UK
Declarações
MH has lectured on ME and made national and international presentations to groups concerned with ME in Denmark, Sweden, Australia, US, and UK. He has acted as a witness for the GMC (UK) and received payment for this (travel and subsistence). He has also received payment from a family he supported in legal proceedings relating to vaccine damage, after the case was settled in their favour. He is a founder member of the Academy Of Nutritional Medicine, which has a special interest in Lyme disease. Their guidelines mention ME/CFS several times. He has given their keynote address for 3 years. He is the author of the paper Hooper M. Myalgic encephalomyelitis: a review with emphasis on key findings in biomedical research. J Clin Pathol. 2007;60:466-71. He is a member of the trustees for the John Richardson Research Group and the ME research group. He is also a trustee of European Services for People with Autism (ESPA) and a member of ESPA-Research, which is developing techniques to help with this condition. All of this work is voluntary.
Diagnósticos diferenciais
- Enxaqueca
- Ansiedade
- Transtorno depressivo maior
Mais Diagnósticos diferenciaisDiretrizes
- Myalgic encephalomyelitis/chronic fatigue syndrome: symptoms and diagnosis of ME/CFS
- Beyond myalgic encephalomyelitis/chronic fatigue syndrome: redefining an illness
Mais DiretrizesFolhetos informativos para os pacientes
Chronic fatigue syndrome
Depression in adults: what is it?
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