P De Becker 1, PhD , J Nijs 1,, PT, N McGregor, PhD, MDSc 2 and K De Meirleir 1, MD, PhD
1: Dept. of Human Physiology,
Vrije Universiteit Brussel,
2: Collaborative Pain Research Unit
Department of Biological Sciences
Faculty of Science
University of Newcastle,
New South Wales,
Etiology of CFS: the Belgian experience
We collected data on 1546 CFS patients and 309 excluded fatigued patients who presented at the Fatigue Clinic at the Vrije Universiteit Brussel. Using extensive present and past medical history and lab reports as close as possible to the date of onset, an attempt was made to identify the agents that could play a role in the disease process. Data were analysed using c2, odds ratio and discriminant function analyses. Differences in the types of event reported at onset were also noted for those subjects who reported a sudden as distinct from a gradual onset and when comparing the defined CFS patients and those excluded under the definitions.
Odds ratio analysis revealed a series of subgroups of events that occurred at onset of CFS. Each of these onset event clusters was associated with an infectious event, blood transfusion or hepatitis B vaccination. In half of our study group two preceding factors were observed; an infectious event was often combined with a non-infectious event. Eight combinations of onset factors were increased in CFS patients compared with the excluded non-CFS patients.
In conclusion, infectious agents seem to play an important role in the onset of CFS. Upper respiratory tract infection was the most common preceding illness before the development of CFS in our group of patients. The simultaneous occurrence of infectious and non-infectious factors seems to be important onset associated events of CFS. In summary, we can conclude that a number of different stressors and consequent immunological and neuroendocrinological changes can contribute to the onset of CFS.
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