Chronic fatigue syndrome: thoughts on pathogenesis.
Studies have shown that a proportion of patients with severe chronic infection due to Epstein-Barr virus (EBV) lack antibody to a component of EBV nuclear antigen. However, it is not clear whether this circumstance is one of cause or effect in regard to the pathogenesis of chronic fatigue syndrome (CFS); it is clearly not pathognomonic since it also occurs in persons infected with the human immunodeficiency virus and--rarely--in those with other EBV-related conditions. Stress and depression may be other pathogenetic mechanisms that could reactivate EBV and lead to CFS; examples of this phenomenon are given. The syndrome might also follow certain other viral infections as part of a process that has been called postinfectious neurasthenia. Currently, the cause(s) and cure of CFS, a common and distressing syndrome, are enigmatic and require multidisciplinary study.
Evans
A S
AS
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06510.
D015673:Fatigue Syndrome, Chronic / Q000209:etiology*; D006566:Herpesviridae Infections / Q000150:complications; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D009440:Neurasthenia / Q000209:etiology