最近审阅: 25 十月 2020
最近更新: 11 九月 2018

小结

定义

病史和体格检查

关键诊断因素

  • 持续失能性疲劳
  • 劳累后不适/疲劳 (PEM)、劳累性虚脱
  • 短期记忆和/或集中力受损
  • 咽痛
  • 全身性关节痛,无炎症
  • 发生于疲劳后的头痛/偏头痛
  • 不能恢复精神的睡眠
  • 体位性不耐受
  • 弥散性肌肉、肌腱、筋膜和其他部位疼痛。
  • 淋巴结触痛

其他诊断因素

  • 发病年龄(青少年期和 30-50 岁)
  • 流感样症状(不适、肌痛、发热)
  • 眩晕{0}/{1}头晕
  • 焦虑、情感障碍、非典型抑郁症
  • 体温改变的感觉
  • 劳累诱导性认知功能障碍(影响工作记忆,非持续性)
  • 刺激物敏感
  • 发热

危险因素

  • 女性
  • 青少年 EB 病毒感染
  • CFS/ME 家族史阳性
  • 遗传因素
  • 成人特定传染病
  • 自身免疫
  • 肠道菌群
  • 心理因素
  • 严重抑郁障碍 (MDD)
  • 血统
  • 关节过度活动/松弛

诊断性检查

首要检查

  • DePaul 症状问卷
  • 全血细胞计数 (FBC) 与白细胞 (WBC) 分类计数
  • 红细胞沉降率
  • C 反应蛋白 (CRP)
  • 综合代谢检查
  • 甲状腺刺激激素
  • 抗核抗体 (ANA)、类风湿因子
  • HIV 抗体检测
更多 首要检查

需考虑的检查

  • 如果存在有症状的直立不耐受,则进行直立倾斜试验;
  • 血清铁蛋白水平
  • HbA1c
  • 尿毒物学筛查
  • 针对麸质敏感/乳糜泻的抗体检测
更多 需考虑的检查

新兴检查

  • 2 天心肺运动试验
更多 新兴检查

治疗流程

进行中

撰稿人

James N. Baraniuk

Professor

Division of Rheumatology, Immunology, and Allergy

Georgetown University

Washington

DC

利益声明

JNB declares that he has no competing interests.

Dr James N. Baraniuk would like to gratefully acknowledge Dr Craig N. Sawchuk and Dr Dedra Buchwald, previous contributors to this topic. 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.

同行评议者展开全部内容

Consultant Psychiatrist in Psychological Medicine

South London and Maudsley NHS Foundation Trust

Denmark Hill

London

UK

利益声明

AS declares that he was a guideline development group member for NICE CFS/ME 2007 guidelines CG53.

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

利益声明

BZK declares that he has no competing interests.

Associated Professor in Rehabilitation Medicine

Department of Clinical Sciences

Danderyd University Hospital

Karolinska Institutet

Stockholm

Sweden

利益声明

IB-L declares that he has no competing interests.

Consultant Physician in Rehabilitation Medicine

Wrightington, Wigan and Leigh NHS Trust

Leigh Infirmary

Leigh

UK

利益声明

TG declares that he has no competing interests.

ME patient advocate

Emeritus Professor of Medicinal Chemistry

University of Sunderland

Sunderland

UK

利益声明

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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