March 5, 2015 – Objective Evidence


Anchor lead: There is evidence from testing to help make the diagnosis of chronic fatigue syndrome or systemic exercise intolerance disease, Elizabeth Tracey reports

If you suspect you have chronic fatigue syndrome, newly renamed SEID or systemic exercise intolerance disease, how is the diagnosis made?  Peter Rowe, an SEID expert at Johns Hopkins and one member of a recent Institute of Medicine panel on the condition, describes the criteria.

Rowe: People with CFS, when they’re tested on consecutive days using a cardiopulmonary exercise test have a drop off in their exercise capability not related to effort, and that’s very different from any other disease including just simple deconditioning.  The three main things you need to have: reduction in your activity level, post-exertional malaise and unrefreshing sleep.  In addition you can either have cognitive dysfunction or orthostatic intolerance.   :27

Orthostatic intolerance refers to someone’s inability to stand or even be seated for a long period of time. Rowe says in children and teenagers, this symptom may show up as reluctance to go to the mall, a sure sign of trouble in this population.  At Johns Hopkins, I’m Elizabeth Tracey.