[Nmefman-legal] Pathology of ME/CFS - Pilot study of four autopsy cases (addition)

From: Charles Shepherd <charles.c.shepherd(a)BTINTERNET.COM&gt; Date: January 9, 2011 9:09:06 AM EST Reply-To: Charles Shepherd <charles.c.shepherd(a)BTINTERNET.COM&gt; Pathology of Chronic Fatigue Pilot Study of Four Autopsy CasesPlease could you add the full text of conference presentation abstract to my original posting as some people are having difficulty in finding it on the MEA website. Thanks CS Pathology of Chronic Fatigue Syndrome: Pilot Study of Four Autopsy Cases DG O'Donovan1, 2, T Harrower3, S Cader2, LJ Findley2, C Shepherd4, A Chaudhuri2 1Addenbrooke's Hospital Cambridge UK 2Queen's Hospital Romford Essex UK 3Royal Devon & Exeter Hospitals UK 4Honorary Medical Advisor to ME Association UK Chronic Fatigue Syndrome / Myalgic Encephalomyelitis is a disorder characterised by chronic exercise induced fatigue, cognitive dysfunction, sensory disturbances and often pain. The aetiology and pathogenesis are not understood. We report the post mortem pathology of four cases of CFS diagnosed by specialists. The causes of death were all unnatural and included: suicidal overdose, renal failure due to lack of food and water, assisted suicide and probable poisoning. Selected portions of tissue were made available by the various Coroners in the UK and with the assent of the persons in a qualifying relationship. The cases were 1 male, and 3 female. Ages (years) M32, F32, F43 & F31. One case showed a vast excess of corpora amylacea in spinal cord and brain of unknown significance but Polyglucosan Body Disease was not supported by clinicopathologial review. No ganglionitis was identified. One case showed a marked dorsal root ganglionitis and two other cases showed mild excess of lymphocytes with nodules of nageotte in the dorsal root ganglia. This raises the hypothesis that dysfunction of the sensory and probably also the autonomic nervous system may lead to abnormal neural activity eg hyperalgesia & allodynia rather than anaesthesia and may explain some of the symptoms of CFS / ME such as pain, hypotension, hyperacusis and photophobia. However, the syndrome may be heterogeneous. Nevertheless, the precise relationship of fatigue, which may be either peripheral or central, to abnormalities in the peripheral nervous system (PNS) needs to be studied. The differential diagnosis of ganglionitis should be investigated in CFS / ME patients hence Varicella Zoster, Lyme disease, HIV, Sjogren's disease, paraneoplastic sensory ganglionopathy should be excluded by appropriate history and tests. Thorough histopathological study of cases coming to autopsy may help to confirm or refute the hypothesis, that CFS is a disease process, and whether the symptomatology may be explained by inflammation of the sensory and autonomic divisions of the PNS. A specific CFS / ME brain and tissue bank in the UK is proposed. --------------------------------------------- Send posts to CO-CURE(a)listserv.nodak.edu Unsubscribe at http://www.co-cure.org/unsub.htm Co-Cure Archives: http://listserv.nodak.edu/archives/co-cure.html --------------------------------------------- Co-Cure's purpose is to provide information from across the spectrum of opinion concerning medical, research and political aspects of ME/CFS and/or FMS. We take no position on the validity of any specific scientific or political opinion expressed in Co-Cure posts, and we urge readers to research the various opinions available before assuming any one interpretation is definitive. The Co-Cure website <www.co-cure.org> has a link to our complete archive of posts as well as articles of central importance to the issues of our community. ---------------------------------------------