Journal of IiME Volume 1 Issue 1 INFORMATION ON ME/CFS (continued) EPIDEMIOLOGY OF ME/CFS Various papers on the epidemiology of ME/CFS reveal that considerable misinformation exists regarding the appropriate evaluation of ME/CFS (including age, gender, occupation, geographical location, length and severity of illness) but that there is increasing understanding of the prevalence, incidence, risk factors, illness patterns and prognosis of this complex multi-system disorder, and emphasis is placed on the importance of subgroups. Although ME/CFS is one of the commonest chronic neurological conditions in the UK today, no official government-sponsored statistical evaluation has yet been made, possibly due to the heterogeneity of the disorder and the lack of a concise case definition. NEUROENDOCRINE ABNORMALITIES IN ME/CFS This section shows evidence for and implications of the endocrine disruption found in ME/CFS, especially that associated with hypothalamic-pituitary-adrenal axis dysfunction. CT scans of the adrenal glands have revealed that both the right and left adrenal glands of some ME/CFS patients are reduced in size by 50% when compared with healthy controls. NEUROLOGICAL ABNORMALITIES IN ME/CFS (including vertigo and seizures) These papers show commonly found dysfunction in both the central nervous system and in the autonomic nervous system; they include papers on dysequilibrium and vertigo which are known components of severe ME/CFS, and there is evidence that seizures may occur in ME/CFS. DEMYELINATION IN ME/CFS Evidence of demyelination and cerebral oedema has been documented in the ME /CFS literature since 1988. OCULAR PROBLEMS IN ME/CFS There is evidence that such problems include intermittent jelly-like nystagmus; difficulty in accommodation / focusing / visual acuities; photosensitivity; photophobia; blurred vision; double vision; crusted eyes; dry eyes; itchiness; narrowed arterioles; retinal defects; fibrillar changes in vitreous; chorioretinal macular abnormalities and optic pallor (the latter is also observed in MS). Objective findings of the anterior segment suggest an organic aetiology. LIVER / SPLEEN INVOLVEMENT IN ME/CFS Published evidence shows that enlargement of the spleen and liver is not unusual. Evidence shows infiltration of the splenic sinuses by atypical lymphoid cells, with reduction in white pulp, suggesting a chronic inflammatory process. HAIR LOSS IN ME/CFS Hair loss in ME/CFS is documented in the literature. One author states “It is a rare woman with CFS who has not had hair loss, usually diffuse and non-scarring”. Elsewhere, it is documented as occurring in 20% of patients. MOUTH ULCERS IN ME/CFS Mouth ulcers have been documented in the ME literature since 1955. VIROLOGY IN ME/CFS Evidence reveals the known tropism of Coxsackie B viruses for muscle, brain, heart and pancreas, all of which are documented as being target organs in ME. There is also evidence of human herpes virus 6 (HHV6) reactivation playing a role in the pathogenesis of both ME/CFS and MS. HHV6 Variant A is more common in AIDS and ME/CFS, whilst Variant B is found in MS. HHV6 used to be called human B-lymphotropic virus (HBLV); it was discovered in 1986. It is possible that reactivation of a composite viral load occurs as an epiphenomenon of an underlying immune system dysfunction, thus giving rise to the protean symptomatology. (continued on page 44) 43 Invest in ME Charity Nr 1114035 www.investinme.org
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