Journal of IiME Volume 1 Issue 2 COMPREHENSIVE TREATMENTS of CFS/ME WITH IVIG By Dr. Tae H. Park CFS/ME Clinic of Seoul, South Korea PURPOSE OF STUDY: To see the effectiveness of low dose gammaglobuline treatment in CFS/ME patients with strict control of diet, activities and sleep. As is commonly known the research into CFS/ME patients is progressing rapidly, but treatments of CFS/ME patients in the clinical frontline is very limited, and most of the treatments are aimed toward the symptomatic relief of CFS/ME. Here (in South Korea), we have 10 years experience of treating CFS/ME with IVIG, strict diet control, ample hydration and activity or exercise control. Overall the response rate is 90% with these regimens. Those who responded had returned to work and resumed normal activities. Contrary to the CDC report that initial symptoms are important for the prognosis of CFS/ME, our study showed that the severity and duration of sx of CFS/ME are not major determinants of prognosis (J.Reeves CDC). There have been several reports about IV gammaglobuline therapy (K.S.Row, Lloyd) but the cost and adverse effect of IVIG treatments prevent CFS/ME patients to have IVIG tx. Further more, the results of IVIG tx are not significant enough to recommend for general use for CFS/ME patients Except Dr.Row’s report that 75-80% of children return to normal school activities and 5-6 yr follow-up also showed the significant improvements. Selection of patients Among our clinic’s 5378 patients, we selected 50 patients who met the 1994 Fukuda criteria in random fashion. Duration of illness: from 2 years to 15 years Ages of patients: Gender: Method of treatments Sleep control: Sleep before midnight and at least 7 hours sleep. If there is DIMS (difficulties in initiating and maintaining sleep), used klonopine and (or) prozac (10-20mg) at night. 18 to 50 male: 28 female:22 Dr Tae Park M.D. Dr.Park runs his own CFS clinic in Seoul, Korea. Dr. Park attended the Invest in ME International ME/CFS Conference in London in May 2007 and has subsequently supplied this and the following articles. Diet control Organic foods: rice and vegetables Avoidance of certain foods: bread, canned food, coffee, chocolate, monosodium glutamate, aspartame and hot peppers, orange juice, carbonated beverages. A high protein diet (but avoidance of pork). Ample hydration 2-3 litres of water with 2 tsp of salt. Strict control of exercise and activities. No heavy lifting (anything using upper extremities – such as house cleaning) is prohibited. Walking is allowed if patient improves. If the patient feels any post-exertional malaise, then reduce the exercise. IV Gammaglobuline One gram per week in 500cc of 0.9% normal saline infused over one hour. Avoid NSAID (non-steroidal anti-inflammatory drugs) medication, and avoid tests using contrast media (like CT-scan, or IVP) How to have rest Rest (like monks meditate), No loud music and no reading books. In acute stages, absolutely no exercise. If anyone does exercise they may develop cardiomyopathy or severe cardiac arrhythmia - even death. Results of treatment 90% of patients who were treated with the above regimens recovered and returned to work, or returned to school. Showed KS score from 40 to 90. The fatigue impact scale improved from 120 to 20-40. Especially, we found improvements in the cognitive functions. We found improvements in concentration and comprehension, but short-term memory is the last to recover. Most of our CFS/ME patients showed impaired renal functions. They showed reduced GFR (glomerular filtration rate) and when compared with normal controls (Park, presented at Japan CFS/ME conference 2007). (continued on page 6) Invest in ME Charity Nr 1114035 Page 5/72 www.investinme.org
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