[Chronic fatigue syndrome: A new disorder?]
More than 30 years after its individualization, chronic fatigue syndrome (CFS) remains a debilitating condition for the patient and a confusing one to the physicians, both because of diagnostic difficulties and poorly codified management. Despite the numerous work carried out, its pathophysiology remains unclear, but a multifactorial origin is suggested with triggering (infections) and maintenance (psychological) factors as well as the persistence of inflammatory (low grade inflammation, microglial activation…), immunologic (decrease of NK cells, abnormal cytokine production, reactivity to a variety of allergens, role of estrogens…) and muscular (mitochondrial dysfunction and failure of bioenergetic performance) abnormalities at the origin of multiple dysfunctions (endocrine, neuromuscular, cardiovascular, digestive…). The complexity of the problem and the sometimes contradictory results of available studies performed so far are at the origin of different pathophysiological and diagnostic concepts. Based on a rigorous analysis of scientific data, the new American concept of Systemic Disease Exertion Intolerance proposed in 2015 simplifies the diagnostic approach and breaks with the past and terminologies (CFS and myalgic encephalomyelitis). It is still too early to distinguish a new disease, but this initiative is a strong signal to intensify the recognition and management of patients with CFS and stimulate research.
Faculté de médecine, université de Lorraine, département de médecine interne et d'immunologie clinique, CHU de Nancy, hôpital de Brabois-BPC, rue du Morvan, 54511 Vandœuvre-lès-Nancy cedex, France. Electronic address: jd.dekorwin@chu-nancy.fr.
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de Korwin
Service de médecine interne, hôpital européen, 6, rue Désirée-Clary, 13003 Marseille, France.
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Chiche
UPRES PSY-NCA, EA 4700, UFR des sciences de l'homme et de la société, rue Lavoisier, 76821 Mont-Saint-Aignan, France.
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Banovic
Pôle cardiovasculaire et thoracique, laboratoire de physiologie respiratoire - explorations à l'exercice, hôpital Nord, AP-HM, Aix-Marseille université, MD, DS-ACI, UMR 2, 13915 Marseille, France.
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Ghali
Service de médecine interne, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France.
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Delliaux
Centre de référence des maladies neuromusculaires, CHU Henri-Mondor, DHU Pepsy, AP-HP, Inserm U955-Eq.10 « biologie du système neuromusculaire », faculté de médecine de Créteil, 94000 Créteil, France.
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Authier
Immunologie clinique, hôpital Édouard-Herriot-Pavillon F, UFR de médecine Lyon-Est, université Claude-Bernard-Lyon-1, 69437 Lyon cedex 03, France.
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Cozon
Service de médecine interne, centre national de référence maladies rares, CHU Huriez, place de Verdun, 59037 Lille, France.
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Hatron
Université de Strasbourg, faculté de psychologie, 12, rue Goethe, 67000 Strasbourg, France.
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Fornasieri
Pôle biologie-pathologie-physiologie, hôpital Saint-Louis, AP-HP, université Paris-Diderot-Paris-7, 1, avenue Vellefaux, 75010 Paris, France.
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Morinet
D003937:Diagnosis, Differential; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans
Autoimmune diseases; Chronic fatigue syndrome; Encéphalomyélite myalgique; Fibromyalgia; Fibromyalgie; Immunologic disorders; Immunopathologie; Infections; Inflammation; Maladies auto-immunes; Myalgic encephalomyelitis; Syndrome de fatigue chronique; Syndrome d’intolérance systémique à l’effort; Systemic exertion intolerance disease