Myalgic Encephalomyelitis Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols : A Consensus Document

An important medical milestone for anyone connected with ME/CFS! Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols includes a clinical definition (clinical diagnostic criteria) for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The clinical case definition was developed by an expert medical consensus panel of treating physicians, teaching faculty and world leaders in the research of ME/CFS. An expert subcommittee of Health Canada established the Terms of Reference for the consensus panel. The definition more adequately reflects the complexity of symptoms of a given patient’s pathogenesis and should establish ME/CFS as a distinct medical entity and help distinguish it from overlapping medical conditions in the absence of a definitive laboratory test. “The clinical definition will enable clinicians to make an early diagnosis which may assist in lessening the impact of ME/CFS in some patients,” said Dr. Bruce M. Carruthers, lead author of the definition. “It will reduce the expensive problem of patients being sent to many specialists before being diagnosed and will allow patients to receive appropriate treatments in a timely fashion.” The panel's clinical case definition determines that more of the prominent symptoms are compulsory and symptoms that share a common region of pathogenesis are grouped together for clarity. In addition to severe prolonged fatigue, the definition includes the hallmark symptoms of post-exertional malaise and/or fatigue, sleep dysfunction, pain, two or more of the given neurological/cognitive manifestations, and at least one of the given symptoms from two of the categories of autonomic, neuroendocrine, and immune manifestations. Diagnostic exclusions and common co-morbid entities are also given. The special issue of the Journal of Chronic Fatigue Syndrome also includes a discussion of prominent symptoms, clinical practice diagnostic and treatment guidelines based on the best available research evidence, and an overview of available research on ME/CFS. The expert panel of 11 physicians—who have diagnosed and/or treated more than 20,000 ME/CFS patients between them—has developed a clinical case definition that provides a flexible conceptual framework based on the characteristic patterns of symptom clusters, which reflect specific areas of pathogenesis. The expert subcommittee of Health Canada selected the expert consensus panel. Authors include: Dr. Bruce M. Carruthers, lead author of the consensus document; co-author of the draft of the original version of the ME/CFS clinical definition, diagnostic and treatment protocols document; internal medicine, Galiano, British Columbia. Dr. Anil Kumar Jain, co-author of the draft the original version of the ME/CFS consensus document, affiliate of Ottawa Hospital, Ontario. Dr. Kenny L. De Meirleir, Professor Physiology and Medicine, Vrije Universiteit Brussel, Brussels, Belgium; ME/CFS researcher and clinician; organizer of the World Congress on Chronic Fatigue Syndrome and Related Disorders; a board member of the American Association for Chronic Fatigue Syndrome; and co-editor of Chronic Fatigue Syndrome: Critical Reviews and Clinical Advances (Haworth) Dr. Daniel L. Peterson, affiliate of the Sierra Internal Medicine Associates in Incline Village, Nevada; ME/CFS researcher and clinician; a board member of the American Association for Chronic Fatigue Syndrome; and member of the International Chronic Fatigue Syndrome Study Group Dr. Nancy G. Klimas, Clinical Professor of Medicine in Microbiology/Immunology/Allergy and Psychology, University of Miami School of Medicine; ME/CFS researcher and clinician; a board member of the American Association for Chronic Fatigue Syndrome; and member of the federal CFS Coordinating Committee Dr. A. Martin Lerner, staff physician at William Beaumont Hospital in Royal Oak, Michigan; Clinical professor and former chief of the Division of Infectious Diseases at Wayne State University's School of Medicine; and ME/CFS researcher and clinician Dr. Alison C. Bested, haematological pathologist; former head of the Division of Haematology and Immunology at the Toronto East General and Orthopaedic Hospital; affiliate of the Environmental Health Clinic and Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario; ME/CFS researcher and clinician Dr. Pierre Flor-Henry, Clinical Professor of Psychiatry, University of Alberta; Clinical Director of General Psychiatry and Director of the Clinical Diagnostic and Research Centre, both based at Alberta Hospital in Edmonton, Alberta, Canada; ME/CFS brain researcher Dr. Pradip Joshi, internal medicine, Clinical Associate Professor of Medicine at Memorial University of Newfoundland in St. John's, Canada Dr. A. C. Peter Powles, Professor Emeritus, Faculty of Health Science, McMasters University, Hamilton; Professor, Faculty of Medicine, University of Toronto; Chief of Medicine and Sleep Disorders Consultant, St. Joseph's Health Centre, Toronto; Sleep Disorder Consultant at the Sleep Disorder Clinic at St. Joseph's Healthcare, Hamilton, and Central West Sleep Affiliation, Paris, Ontario Dr. Jeffrey A. Sherkey, family medicine, affiliate of the University Health Network, Toronto, Ontario; and diagnosed with chronic fatigue syndrome nearly 10 years ago Marjorie I. van de Sande, Consensus Coordinator; and Director of Education for the National ME/FM Action Network, Canada Myalgic Encephalomyelitis / Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols also addresses diagnostic exclusions and common co-morbid entities. This groundbreaking book is must reading for anyone connected with the disease—personally or professionally.