Fibromiyalji ve Yorgunluk
Özet
Fibromiyalji sendromu (FS) ve kronik yorgunluk sendromu (KYS), yaygın kas-iskelet ağrıları, yorgunluk, uyku bozuklukları ve bilişsel zorluklarla karakterize kronik rahatsızlıklardır. Dünya Sağlık Örgütü tarafından tanımlanan FS, irritabl bağırsak sendromu, temporomandibular eklem disfonksiyonu ve ortostatik intolerans gibi çeşitli rahatsızlıklarla ilişkilendirilir. FS'nin en belirgin semptomları arasında yaygın ağrı, ruh hali değişiklikleri ve günlük aktiviteleri yerine getirememe durumu yer alır. KYS ise özellikle dinlenmeyle geçmeyen ve uzun süren yorgunlukla karakterize olup bilişsel, immünolojik ve endokrin bozukluklarla ilişkilendirilir. Her iki sendromun da etiyolojisi tam olarak aydınlatılamamış olup, genetik ve çevresel faktörlerin rol oynadığı düşünülmektedir. KYS ve FS, yorgunluk, yaygın ağrı ve uyku bozuklukları gibi birçok örtüşen semptomla kendini gösteren iki oldukça benzer bozukluk olarak bilinmektedir. Ancak, bu benzerliklere rağmen, iki durumunun da farklı olarak kavramsallaştırmak için yeterli destekleyici veriler bulunmaktadır. FS, ek koşulların varlığında veya yokluğunda tanı konulmasını mümkün kılan bir tanısal varlık olarak değerlendirilmektedir. KYS, başka bir yorgunluk oluşturan bozukluğun varlığını dışlayan, oldukça dışlayıcı bir tanım olarak öne çıkmaktadır. FS ve KYS’nin tedavisi genellikle semptomların yönetimine odaklanır. Farmakolojik tedavide ağrı kesiciler, antidepresanlar ve antikonvülsanlar kullanılırken, egzersiz, bilişsel davranışçı terapi ve fizyoterapi yaklaşımları gibi farmakolojik olmayan yöntemler de önemlidir. Her iki sendrom da yaşam kalitesini düşürmekte ve multidisipliner bir tedavi yaklaşımı gerektirmektedir.
Fibromyalgia syndrome (FS) and chronic fatigue syndrome (CFS) are chronic conditions characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and cognitive difficulties. FS, as defined by the World Health Organization, is associated with various conditions such as irritable bowel syndrome, temporomandibular joint dysfunction, and orthostatic intolerance. The most prominent symptoms of FS include widespread pain, mood disturbances, and an inability to perform daily activities. CFS, on the other hand, is primarily characterized by prolonged fatigue that is not relieved by rest and is associated with cognitive, immunological, and endocrine dysfunctions. The etiology of both syndromes remains unclear, although it is believed that genetic and environmental factors play a role. FS and CFS are recognized as two very similar disorders, as they both present with overlapping symptoms such as fatigue, widespread pain, and sleep disturbances. However, despite these similarities, there is sufficient evidence to conceptualize them as distinct conditions. FS is considered a diagnostic entity that can be identified with or without the presence of additional conditions, whereas CFS is defined more restrictively, excluding the presence of other fatigue-inducing disorders. The treatment of FS and CFS typically focuses on symptom management. Pharmacological treatments include pain relievers, antidepressants, and anticonvulsants, while non-pharmacological approaches such as exercise, cognitive-behavioral therapy, and physiotherapy are also important. Both syndromes significantly reduce quality of life and require a multidisciplinary treatment approach.
Referanslar
Clauw DJ. Fibromyalgia: a clinical review. Jama. 2014;311(15):1547-55.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis care & research. 2010;62(5):600-10.
Giorgi V, Bazzichi L, Batticciotto A, Pellegrino G, Di Franco M, Sirotti S, et al. Fibromyalgia: one year in review 2023. Clinical and experimental rheumatology. 2023;41(6):1205-13.
Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC musculoskeletal disorders. 2007;8:1-11.
Spaeth M. Epidemiology, costs, and the economic burden of fibromyalgia. Springer; 2009. p. 1-2.
White KP, Speechley M, Harth M, Ostbye T. The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. The Journal of rheumatology. 1999;26(7):1570-6.
Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain research and treatment. 2012;2012(1):426130.
Smythe HA, Moldofsky H. Two contributions to understanding of the “fibrositis” syndrome. Bull Rheum Dis. 1977;28(1):928-31.
Wolfe F, Clauw DJ, Fitzcharles M-A, Goldenberg DL, Häuser W, Katz RL, et al., editors. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Seminars in arthritis and rheumatism; 2016: Elsevier.
Ablin JN, Oren A, Cohen S, Aloush V, Buskila D, Elkayam O, et al. Prevalence of fibromyalgia in the Israeli population: a population-based study to estimate the prevalence of fibromyalgia in the Israeli population using the London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ). Clin Exp Rheumatol. 2012;30(6 Suppl 74):39-43.
Topbas M, Cakirbay H, Gulec H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20–64 in Turkey. Scandinavian journal of rheumatology. 2005;34(2).
Arnold LM, Hudson JI, Hess EV, Ware AE, Fritz DA, Auchenbach MB, et al. Family study of fibromyalgia. Arthritis & Rheumatism. 2004;50(3):944-52.
Bondy B, Spaeth M, Offenbaecher M, Glatzeder K, Stratz T, Schwarz M, et al. The T102C polymorphism of the 5-HT2A-receptor gene in fibromyalgia. Neurobiology of disease. 1999;6(5):433-9.
Clauw DJ, Chrousos GP. Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation. 1997;4(3):134-53.
Yunus MB, editor Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Seminars in arthritis and rheumatism; 2007: Elsevier.
Chinn S, Caldwell W, Gritsenko K. Fibromyalgia Pathogenesis and Treatment Options Update. Curr Pain Headache Rep. 2016;20(4):25.
Russell IJ, Michalek JE, Vipraio GA, Fletcher EM, Javors MA, Bowden CA. Platelet 3H-imipramine uptake receptor density and serum serotonin levels in patients with fibromyalgia/fibrositis syndrome. J Rheumatol. 1992;19(1):104-9.
Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities. Can J Anaesth. 2001;48(10):1000-10.
Häuser W, Wolfe F, Tölle T, Uçeyler N, Sommer C. The role of antidepressants in the management of fibromyalgia syndrome: a systematic review and meta-analysis. CNS Drugs. 2012;26(4):297-307.
Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020;16(11):645-60.
Koroschetz J, Rehm SE, Gockel U, Brosz M, Freynhagen R, Tölle TR, et al. Fibromyalgia and neuropathic pain-differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC neurology. 2011;11:1-8.
Rehm SE, Koroschetz J, Gockel U, Brosz M, Freynhagen R, Tölle TR, et al. A cross-sectional survey of 3035 patients with fibromyalgia: subgroups of patients with typical comorbidities and sensory symptom profiles. Rheumatology. 2010;49(6):1146-52.
Rossi A, Di Lollo AC, Guzzo MP, Giacomelli C, Atzeni F, Bazzichi L, et al. Fibromyalgia and nutrition: what news. Clin Exp Rheumatol. 2015;33(1 Suppl 88):S117-25.
Bossema ER, Van Middendorp H, Jacobs JW, Bijlsma JW, Geenen R. Influence of weather on daily symptoms of pain and fatigue in female patients with fibromyalgia: a multilevel regression analysis. Arthritis Care & Research. 2013;65(7):1019-25.
Casale R, Sarzi-Puttini P, Botto R, Alciati A, Batticciotto A, Marotto D, et al. Fibromyalgia and the concept of resilience. Clin Exp Rheumatol. 2019;37(Suppl 116):105-13.
Kleinman L, Mannix S, Arnold LM, Burbridge C, Howard K, McQuarrie K, et al. Assessment of sleep in patients with fibromyalgia: qualitative development of the fibromyalgia sleep diary. Health and quality of life outcomes. 2014;12:1-11.
Sandıkçı SC, Özbalkan Z. Fatigue in rheumatic diseases. European journal of rheumatology. 2015;2(3):109.
Glass JM. Review of cognitive dysfunction in fibromyalgia: a convergence on working memory and attentional control impairments. Rheumatic Disease Clinics. 2009;35(2):299-311.
Walitt B, Fitzcharles M-A, Hassett AL, Katz RS, Häuser W, Wolfe F. The longitudinal outcome of fibromyalgia: a study of 1555 patients. The Journal of rheumatology. 2011;38(10):2238-46.
Ifergane G, Buskila D, Simiseshvely N, Zeev K, Cohen H. Prevalence of fibromyalgia syndrome in migraine patients. Cephalalgia. 2006;26(4):451-6.
Mathieu N. Somatic comorbidities in irritable bowel syndrome: fibromyalgia, chronic fatigue syndrome, and interstitial cystitis. Gastroenterologie clinique et biologique. 2009;33:S17-25.
Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, et al. AAPT diagnostic criteria for fibromyalgia. The journal of pain. 2019;20(6):611-28.
Vincent A, McAllister SJ, Singer W, Toussaint LL, Sletten DM, Whipple MO, et al. A report of the autonomic symptom profile in patients with fibromyalgia. JCR: Journal of Clinical Rheumatology. 2014;20(2):106-8.
González E, Elorza J, Failde I. Fibromyalgia and psychiatric comorbidity: their effect on the quality of life patients. Actas Españolas de Psiquiatría. 2010;38(5):295-300.
Brurberg KG, Fønhus MS, Larun L, Flottorp S, Malterud K. Case defnitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review. BMJ Open. 2014;4:e003973.
Carruthers BM, Jain AK, DeMeirleir KL, Peterson D, Klimas NG, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case defnition, diagnostic and treatment protocols. J Chronic Fatigue Syndr. 2003;11:7–36.
Castro-Marrero J, Faro M, Aliste L, Sáez-Francàs N, Calvo N, Martínez-Martínez A, de Sevilla TF, Alegre J. Comorbidity in chronic fatigue syndrome/myalgic encephalomyelitis: a nationwide population-based cohort study. Psychosomatics. 2017;58:533–43.
Komaroff AL. Advances in understanding the pathophysiology of chronic fatigue syndrome. JAMA. 2019;
Noda M, Ifuku M, Hossain MS, Katafuchi T. Glial activation and expression of the serotonin transporter in chronic fatigue syndrome. Front Psychiatry. 2018;9:589. .
Skowera A, Cleare A, Blair D. High levels of type 2 cytokine-producing cells in chronic fatigue syndrome. Clin Exp Immunol. 2004;135:294–302
Rivas JL, Palencia T, Fernández G, García M. Association of T and NK cell phenotype with the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Front Immunol. 2018;9:1028.
Bradley AS, Ford B, Bansal AS. Altered functional B cell subset populations in patients with chronic fatigue syndrome compared to healthy controls. Clin Exp Immunol. 2013;172:73–80.
Loebel M, Grabowski P, Heidecke H, Bauer S, Hanitsch LG, Wittke K, Meisel C, Reinke P, Volk H-D, Fluge Ø, Mella O, Scheibenbogen C. Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome. Brain Behav Immun. 2016;52:32–9. https://doi.org/10.1016/J.BBI.2015.09.013
Scheibenbogen C, Loebel M, Freitag H, Krueger A, Bauer S, Antelmann M, Doehner W, Scherbakov N, Heidecke H, Reinke P, Volk H-D, Grabowski P. Immunoadsorption to remove ß2 adrenergic receptor antibodies in chronic fatigue syndrome CFS/ME. PLoS One. 2018;13:e0193672. https://doi.org/10.1371/journal.pone.0193672
Tomas C, Newton J, Watson S. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. ISRN Neurosci. 2013; 2013:784520
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A, the International Chronic Fatigue Syndrome Study Group. The chronic fatigue syndrome: a comprehensive approach to its defnition and study. Ann Intern Med. 1994; 121:953–9
Carruthers BM, van de Sande MI, De Meirleir KL, Klimas NG, Broderick G, Mitchell T, Staines D, Powles AC, Speight N, Vallings R, et al. Myalgic encephalomyelitis: International Consensus Criteria. J Intern Med. 2011; 270:327–38.
Buchwald D, Garrity D. Comparison of patients with chronic fatigue syndrome, fbromyalgia, and multiple chemical sensitivities. Arch Intern Med. 1994;154(18):2049.
Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fbromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;160(2):221.
White KP, Speechley M, Harth M, Ostbye T. The London fbromyalgia epidemiology study: the prevalence of fbromyalgia syndrome in London, Ontario. J Rheumatol. 1999;26:1570–6.
Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y. On chronic fatigue syndrome and nosological categories. Clin Rheumatol. 2018;37:1161–70
Natelson BH. Myalgic encephalomyelitis/chronic fatigue syndrome and fbromyalgia: defnitions, similarities and differences. Clin Ther. 2019;41(4):612–8.
Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med. 1999;130:910–21.
Evengård B, Nilsson CG, Lindh G, et al. Chronic fatigue syndrome differs from fbromyalgia. No evidence for elevated substance P levels in cerebrospinal fuid of patients with chronic fatigue syndrome. Pain. 1998;78:153–5
Tsilioni I, Russell IJ, Stewart JM, Gleason RM, Theoharides TC. Neuropeptides CRH, SP, HK-1, and infammatory cytokines IL-6 and TNF are increased in serum of patients with fbromyalgia syndrome, implicating mast cells. J Pharmacol Exp Therap. 2016;356:664–72
Mastrangelo F, Frydas I, Ronconi G, et al. Low-grade chronic infammation mediated by mast cells in fbromyalgia: role of IL-37. J Biol Regul Homeostat Agents. 2018;32:195–8
Pejovic S, Natelson BH, Basta M, Fernandez-Mendoza J, Mahr F, Vgontzas AN. Chronic fatigue syndrome and fbromyalgia in diagnosed sleep disorders: a further test of the ‘unitary’ hypothesis. BMC Neurol. 2015;15:53.
Ciccone DS, Natelson BH. Comorbid illness in the chronic fatigue syndrome: a test of the single syndrome hypothesis. PsychosomMed. 2003;62:268–75
Weaver SA, Janal MN, Aktan N, Ottenweller JE, Natelson BH. Sex differences in plasma prolactin response to tryptophan in Chronic Fatigue Syndrome patients with and without comorbid fbromyalgia. J Womens Health (Larchmt). 2010;3:6–11.
Roy-Byrne P, Smith WR, Goldberg J, Afari N, Buchwald D. Post-traumatic stress disorder among patients with chronic pain and chronic fatigue. Psychol Med. 2004;34:363–8.
Kishi A, Natelson BH, Togo F, Struzik ZR, Rapoport DM, Yamamoto Y. Sleep-stage dynamics in patients with chronic fatigue syndrome with or without fbromyalgia. Sleep. 2011;34:1551–60.
Referanslar
Clauw DJ. Fibromyalgia: a clinical review. Jama. 2014;311(15):1547-55.
Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis care & research. 2010;62(5):600-10.
Giorgi V, Bazzichi L, Batticciotto A, Pellegrino G, Di Franco M, Sirotti S, et al. Fibromyalgia: one year in review 2023. Clinical and experimental rheumatology. 2023;41(6):1205-13.
Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. An internet survey of 2,596 people with fibromyalgia. BMC musculoskeletal disorders. 2007;8:1-11.
Spaeth M. Epidemiology, costs, and the economic burden of fibromyalgia. Springer; 2009. p. 1-2.
White KP, Speechley M, Harth M, Ostbye T. The London Fibromyalgia Epidemiology Study: the prevalence of fibromyalgia syndrome in London, Ontario. The Journal of rheumatology. 1999;26(7):1570-6.
Bellato E, Marini E, Castoldi F, Barbasetti N, Mattei L, Bonasia DE, et al. Fibromyalgia syndrome: etiology, pathogenesis, diagnosis, and treatment. Pain research and treatment. 2012;2012(1):426130.
Smythe HA, Moldofsky H. Two contributions to understanding of the “fibrositis” syndrome. Bull Rheum Dis. 1977;28(1):928-31.
Wolfe F, Clauw DJ, Fitzcharles M-A, Goldenberg DL, Häuser W, Katz RL, et al., editors. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Seminars in arthritis and rheumatism; 2016: Elsevier.
Ablin JN, Oren A, Cohen S, Aloush V, Buskila D, Elkayam O, et al. Prevalence of fibromyalgia in the Israeli population: a population-based study to estimate the prevalence of fibromyalgia in the Israeli population using the London Fibromyalgia Epidemiology Study Screening Questionnaire (LFESSQ). Clin Exp Rheumatol. 2012;30(6 Suppl 74):39-43.
Topbas M, Cakirbay H, Gulec H, Akgol E, Ak I, Can G. The prevalence of fibromyalgia in women aged 20–64 in Turkey. Scandinavian journal of rheumatology. 2005;34(2).
Arnold LM, Hudson JI, Hess EV, Ware AE, Fritz DA, Auchenbach MB, et al. Family study of fibromyalgia. Arthritis & Rheumatism. 2004;50(3):944-52.
Bondy B, Spaeth M, Offenbaecher M, Glatzeder K, Stratz T, Schwarz M, et al. The T102C polymorphism of the 5-HT2A-receptor gene in fibromyalgia. Neurobiology of disease. 1999;6(5):433-9.
Clauw DJ, Chrousos GP. Chronic pain and fatigue syndromes: overlapping clinical and neuroendocrine features and potential pathogenic mechanisms. Neuroimmunomodulation. 1997;4(3):134-53.
Yunus MB, editor Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Seminars in arthritis and rheumatism; 2007: Elsevier.
Chinn S, Caldwell W, Gritsenko K. Fibromyalgia Pathogenesis and Treatment Options Update. Curr Pain Headache Rep. 2016;20(4):25.
Russell IJ, Michalek JE, Vipraio GA, Fletcher EM, Javors MA, Bowden CA. Platelet 3H-imipramine uptake receptor density and serum serotonin levels in patients with fibromyalgia/fibrositis syndrome. J Rheumatol. 1992;19(1):104-9.
Kelly DJ, Ahmad M, Brull SJ. Preemptive analgesia I: physiological pathways and pharmacological modalities. Can J Anaesth. 2001;48(10):1000-10.
Häuser W, Wolfe F, Tölle T, Uçeyler N, Sommer C. The role of antidepressants in the management of fibromyalgia syndrome: a systematic review and meta-analysis. CNS Drugs. 2012;26(4):297-307.
Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020;16(11):645-60.
Koroschetz J, Rehm SE, Gockel U, Brosz M, Freynhagen R, Tölle TR, et al. Fibromyalgia and neuropathic pain-differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia. BMC neurology. 2011;11:1-8.
Rehm SE, Koroschetz J, Gockel U, Brosz M, Freynhagen R, Tölle TR, et al. A cross-sectional survey of 3035 patients with fibromyalgia: subgroups of patients with typical comorbidities and sensory symptom profiles. Rheumatology. 2010;49(6):1146-52.
Rossi A, Di Lollo AC, Guzzo MP, Giacomelli C, Atzeni F, Bazzichi L, et al. Fibromyalgia and nutrition: what news. Clin Exp Rheumatol. 2015;33(1 Suppl 88):S117-25.
Bossema ER, Van Middendorp H, Jacobs JW, Bijlsma JW, Geenen R. Influence of weather on daily symptoms of pain and fatigue in female patients with fibromyalgia: a multilevel regression analysis. Arthritis Care & Research. 2013;65(7):1019-25.
Casale R, Sarzi-Puttini P, Botto R, Alciati A, Batticciotto A, Marotto D, et al. Fibromyalgia and the concept of resilience. Clin Exp Rheumatol. 2019;37(Suppl 116):105-13.
Kleinman L, Mannix S, Arnold LM, Burbridge C, Howard K, McQuarrie K, et al. Assessment of sleep in patients with fibromyalgia: qualitative development of the fibromyalgia sleep diary. Health and quality of life outcomes. 2014;12:1-11.
Sandıkçı SC, Özbalkan Z. Fatigue in rheumatic diseases. European journal of rheumatology. 2015;2(3):109.
Glass JM. Review of cognitive dysfunction in fibromyalgia: a convergence on working memory and attentional control impairments. Rheumatic Disease Clinics. 2009;35(2):299-311.
Walitt B, Fitzcharles M-A, Hassett AL, Katz RS, Häuser W, Wolfe F. The longitudinal outcome of fibromyalgia: a study of 1555 patients. The Journal of rheumatology. 2011;38(10):2238-46.
Ifergane G, Buskila D, Simiseshvely N, Zeev K, Cohen H. Prevalence of fibromyalgia syndrome in migraine patients. Cephalalgia. 2006;26(4):451-6.
Mathieu N. Somatic comorbidities in irritable bowel syndrome: fibromyalgia, chronic fatigue syndrome, and interstitial cystitis. Gastroenterologie clinique et biologique. 2009;33:S17-25.
Arnold LM, Bennett RM, Crofford LJ, Dean LE, Clauw DJ, Goldenberg DL, et al. AAPT diagnostic criteria for fibromyalgia. The journal of pain. 2019;20(6):611-28.
Vincent A, McAllister SJ, Singer W, Toussaint LL, Sletten DM, Whipple MO, et al. A report of the autonomic symptom profile in patients with fibromyalgia. JCR: Journal of Clinical Rheumatology. 2014;20(2):106-8.
González E, Elorza J, Failde I. Fibromyalgia and psychiatric comorbidity: their effect on the quality of life patients. Actas Españolas de Psiquiatría. 2010;38(5):295-300.
Brurberg KG, Fønhus MS, Larun L, Flottorp S, Malterud K. Case defnitions for chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a systematic review. BMJ Open. 2014;4:e003973.
Carruthers BM, Jain AK, DeMeirleir KL, Peterson D, Klimas NG, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, et al. Myalgic encephalomyelitis/chronic fatigue syndrome: clinical working case defnition, diagnostic and treatment protocols. J Chronic Fatigue Syndr. 2003;11:7–36.
Castro-Marrero J, Faro M, Aliste L, Sáez-Francàs N, Calvo N, Martínez-Martínez A, de Sevilla TF, Alegre J. Comorbidity in chronic fatigue syndrome/myalgic encephalomyelitis: a nationwide population-based cohort study. Psychosomatics. 2017;58:533–43.
Komaroff AL. Advances in understanding the pathophysiology of chronic fatigue syndrome. JAMA. 2019;
Noda M, Ifuku M, Hossain MS, Katafuchi T. Glial activation and expression of the serotonin transporter in chronic fatigue syndrome. Front Psychiatry. 2018;9:589. .
Skowera A, Cleare A, Blair D. High levels of type 2 cytokine-producing cells in chronic fatigue syndrome. Clin Exp Immunol. 2004;135:294–302
Rivas JL, Palencia T, Fernández G, García M. Association of T and NK cell phenotype with the diagnosis of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Front Immunol. 2018;9:1028.
Bradley AS, Ford B, Bansal AS. Altered functional B cell subset populations in patients with chronic fatigue syndrome compared to healthy controls. Clin Exp Immunol. 2013;172:73–80.
Loebel M, Grabowski P, Heidecke H, Bauer S, Hanitsch LG, Wittke K, Meisel C, Reinke P, Volk H-D, Fluge Ø, Mella O, Scheibenbogen C. Antibodies to β adrenergic and muscarinic cholinergic receptors in patients with Chronic Fatigue Syndrome. Brain Behav Immun. 2016;52:32–9. https://doi.org/10.1016/J.BBI.2015.09.013
Scheibenbogen C, Loebel M, Freitag H, Krueger A, Bauer S, Antelmann M, Doehner W, Scherbakov N, Heidecke H, Reinke P, Volk H-D, Grabowski P. Immunoadsorption to remove ß2 adrenergic receptor antibodies in chronic fatigue syndrome CFS/ME. PLoS One. 2018;13:e0193672. https://doi.org/10.1371/journal.pone.0193672
Tomas C, Newton J, Watson S. A review of hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. ISRN Neurosci. 2013; 2013:784520
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A, the International Chronic Fatigue Syndrome Study Group. The chronic fatigue syndrome: a comprehensive approach to its defnition and study. Ann Intern Med. 1994; 121:953–9
Carruthers BM, van de Sande MI, De Meirleir KL, Klimas NG, Broderick G, Mitchell T, Staines D, Powles AC, Speight N, Vallings R, et al. Myalgic encephalomyelitis: International Consensus Criteria. J Intern Med. 2011; 270:327–38.
Buchwald D, Garrity D. Comparison of patients with chronic fatigue syndrome, fbromyalgia, and multiple chemical sensitivities. Arch Intern Med. 1994;154(18):2049.
Aaron LA, Burke MM, Buchwald D. Overlapping conditions among patients with chronic fatigue syndrome, fbromyalgia, and temporomandibular disorder. Arch Intern Med. 2000;160(2):221.
White KP, Speechley M, Harth M, Ostbye T. The London fbromyalgia epidemiology study: the prevalence of fbromyalgia syndrome in London, Ontario. J Rheumatol. 1999;26:1570–6.
Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Martini M, Perricone C, Amital H, Shoenfeld Y. On chronic fatigue syndrome and nosological categories. Clin Rheumatol. 2018;37:1161–70
Natelson BH. Myalgic encephalomyelitis/chronic fatigue syndrome and fbromyalgia: defnitions, similarities and differences. Clin Ther. 2019;41(4):612–8.
Barsky AJ, Borus JF. Functional somatic syndromes. Ann Intern Med. 1999;130:910–21.
Evengård B, Nilsson CG, Lindh G, et al. Chronic fatigue syndrome differs from fbromyalgia. No evidence for elevated substance P levels in cerebrospinal fuid of patients with chronic fatigue syndrome. Pain. 1998;78:153–5
Tsilioni I, Russell IJ, Stewart JM, Gleason RM, Theoharides TC. Neuropeptides CRH, SP, HK-1, and infammatory cytokines IL-6 and TNF are increased in serum of patients with fbromyalgia syndrome, implicating mast cells. J Pharmacol Exp Therap. 2016;356:664–72
Mastrangelo F, Frydas I, Ronconi G, et al. Low-grade chronic infammation mediated by mast cells in fbromyalgia: role of IL-37. J Biol Regul Homeostat Agents. 2018;32:195–8
Pejovic S, Natelson BH, Basta M, Fernandez-Mendoza J, Mahr F, Vgontzas AN. Chronic fatigue syndrome and fbromyalgia in diagnosed sleep disorders: a further test of the ‘unitary’ hypothesis. BMC Neurol. 2015;15:53.
Ciccone DS, Natelson BH. Comorbid illness in the chronic fatigue syndrome: a test of the single syndrome hypothesis. PsychosomMed. 2003;62:268–75
Weaver SA, Janal MN, Aktan N, Ottenweller JE, Natelson BH. Sex differences in plasma prolactin response to tryptophan in Chronic Fatigue Syndrome patients with and without comorbid fbromyalgia. J Womens Health (Larchmt). 2010;3:6–11.
Roy-Byrne P, Smith WR, Goldberg J, Afari N, Buchwald D. Post-traumatic stress disorder among patients with chronic pain and chronic fatigue. Psychol Med. 2004;34:363–8.
Kishi A, Natelson BH, Togo F, Struzik ZR, Rapoport DM, Yamamoto Y. Sleep-stage dynamics in patients with chronic fatigue syndrome with or without fbromyalgia. Sleep. 2011;34:1551–60.
