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Encefalomielite miálgica (síndrome da fadiga crônica)

Última revisão: 1 Nov 2024
Última atualização: 29 May 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • mal-estar/fadiga pós-esforço (PEM; exaustão por esforço)
  • fadiga incapacitante persistente
  • disfunção cognitiva
  • faringite
  • cefaleia
  • alteração do sono
  • intolerância ortostática
  • dor e hiperalgesia
  • linfonodos sensíveis à palpação
Detalhes completos

Outros fatores diagnósticos

  • idade de início (adolescência e 30-50 anos)
  • sintomas tipo gripe (mal-estar, mialgia, sensação de febre)
  • ansiedade, transtorno afetivo
  • sensações de temperatura alterada ou febril
  • sensibilidade a substâncias irritantes
Detalhes completos

Fatores de risco

  • sexo feminino
  • Infecção por Epstein-Barr em adolescentes
  • doença do coronavírus 2019 (COVID-19)
  • história familiar positiva de EM/SFC
  • fatores genéticos
  • doenças infecciosas específicas em adultos
  • autoimunidade
  • disfunção do microbioma intestinal
  • transtorno depressivo maior
  • ascendência
  • hipermobilidade/frouxidão articular
  • achados cardíacos
Detalhes completos

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)
Detalhes completos

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
Detalhes completos

Novos exames

  • teste ergométrico de 2 dias

Algoritmo de tratamento

Contínua

todos os pacientes

Colaboradores

Autores

James N. Baraniuk, MD

Professor

Division of Rheumatology, Immunology, and Allergy

Georgetown University

Washington

DC

Declarações

JNB has received research funding from the Gulf War Illness Research Program and the Congressionally Directed Medical Research Program. He has received travel grants from the Research Advisory Committee on Gulf War Illness. He is an author of one reference cited in the topic.

Sonya Marshall-Gradisnik, PhD, BSc, BSc Hons

​Program Director for Disability and Rehabilitation

Director for National Centre for Neuroimmunology and Emerging Diseases

Menzies Health Institute Queensland

Griffith University

Gold Coast

Australia

Declarações

SM-G is listed either directly or indirectly with two patent applications relating to identifying, screening, diagnosing, or managing/treating people with ME/CFS and long COVID, respectively. She has received several national and international grants with financial support as contracted through Griffith University. She has been a member of the Center for Scientific Review Special Emphasis Panel for ME/CFS at the National Institutes of Health, a reviewer for the Medical Research Council for ME/CFS, UK and Canadian Health for the ME/CFS Research Program. She is a board member of the International Association for ME/CFS, US. Non-reimbursed activities include several lectures on ME/CFS and a role as a lecturer at Griffith University School of Medicine and Dentistry, Queensland, Australia. She has been contacted by the National Academies Sciences, Engineering, and Medicine to complete a comprehensive report on ME/CFS, long COVID, and their similarities extending to the impact on society. She declares that her participation in this document was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. She is an author of several recent abstracts and publications on ME/CFS and long COVID.

Natalie Eaton-Fitch, ​PhD, BHSc, BBiomedSc (Hons)

Post-doctoral Research Fellow

National Centre for Neuroimmunology and Emerging Diseases

Menzies Health Institute Queensland

Griffith University

Gold Coast

Australia

Declarações

NE-F is listed either directly or indirectly with two patent applications relating to identifying, screening, diagnosing, or managing/treating people with ME/CFS and long COVID, respectively. She receives funding from the Stafford Fox Medical Research Foundation, Australia, and has been contacted by the National Academies Sciences, Engineering, and Medicine to complete a comprehensive report on ME/CFS, long COVID, and their similarities extending to the impact on society. She declares that her participation in this document was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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 ME/CFS, 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 ME/CFS 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.

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