Autoimmune Disease

Chronic fatigue immune dysfunction syndrome (CFIDS) is a chronic inflammatory illness of undetermined origin. Four million adults fulfill the criteria for CADS and 7.5 million meet the criteria for CFS-like illness. It is suspected to have an autoimmune component, as many of those diagnosed with CFIDS have circulating antinuclear autoantibodies. Because chronic fatigue is a major symptom in many other illnesses, especially those that are autoimmune, other diseases that are usually ruled out before the diagnosis of CFIDS is made are lupus, multiple sclerosis, Lyme disease, AIDS, antiphospholipid syndrome, thyroid disease, rheumatoid arthritis, fibromyositis, and depression. CFIDS is also referred to as chronic fatigue syndrome and chronic Epstein-Barr virus.

The syndrome is found in both men and women; however, it affects nearly three times as many women as men. All ages, races, and income levels can be affected. Although the illness sometimes breaks out in groups, the vast majority of people who work and live closely with persons who have CFIDS do not get the disease. It is not considered to be easily contagious from one person to another. It could be that a common virus is involved in the development of CFIDS in combination with a genetic predisposition to develop the illness as is the case with some of the autoimmune diseases.

Chronic fatigue syndrome often occurs after a cold, flu, or viral infection. It often has an acute onset. Female hormonal fluctuations may also play a role. Stressors (e.g., infection, trauma, chemical exposure, etc) raise nitric oxide levels excessively in individuals with Chronic Fatigue Syndrome and Fibromyalgia.

Diagnostic Criteria

The diagnosis is made by exclusion of other conditions which often present with similar symptoms. Specific tests to rule out other problems may include:

  • CBC
  • ESR
  • Blood glucose level
  • Thyroid panel
  • Chemistry panel
  • UA
  • Testing for antinuclear antibodies (to check for lupus)
  • Rheumatoid factor
  • HIV, Lyme disease (if the patient has been exposed to ticks)
  • TB
  • Sleep study to rule out primary sleep disorders

The diagnosis of CFIDS must include the following criteria:

  • Fatigue persists or relapses for at least 6 months
  • 4 or more of the following criteria are met:
    • impaired memory or concentration
    • sore throat
    • tender cervical or axillary lymph nodes
    • muscle pain
    • multi-joint pain
    • new headaches
    • un-refreshing sleep
    • post-exertion malaise

Patients often demonstrate other problems as well

  • Irritable bowel syndrome
  • Affective disorders
  • Memory problems
  • Many people who have CFIDS have underlying joint hypermobility and autonomic dysfunction, meaning they don’t regulate thins like heart rate and blood pressure well. Their lax joints predispose them to chronic muscle and joint pain, and their circulatory problems likely contribute to fatigue and cognitive