Patologia del SFC: Estudio piloto de 4 autopsias

[elipoarch]

[t]Pathology of Chronic Fatigue Syndrome: Pilot Study of Four Autopsy Cases[/t]
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.
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Este estudio viene de la puesta en marcha de una propuesta que se hizo en septiembre de 2010 de la organización de un grupo para crear un banco de tejido post-mortem de enfermos de Síndrome de Fatiga Crónica (muertos por causas diversas), para poder estudiar anomalías que puedan dar una idea de la etiología y patogénesis de esta enfermedad.

Os pongo aquí lo que se publicó entonces:


[t]Exploring the feasibility of establishing a disease-specific post-mortem tissue bank in the UK: a case study in ME/CFS[/t]
Eliana M Lacerda1, Luis Nacul1, Derek Pheby2, Charles Shepherd3, Peter Spencer4
1London School of Hygiene & Tropical Medicine, EPH/NPHIRU/CFS/ME Observatory, London, UK
2Buckinghamshire New University, Uxbridge; and CFS/ME Observatory, London, UK
3The ME Association, Gawcott, Buckinghamshire, UK
4Action for ME, Bristol, UK
Correspondence to
Dr Eliana M Lacerda, London School of Hygiene & Tropical Medicine, EPH/NPHIRU/ CFS/ME Observatory, Keppel Street, London EC1E 7HT, UK; [email protected]
Accepted 7 September 2010
Published Online First 5 October 2010

Abstract
Background Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a condition, the aetiology of which remains controversial, and there is still no consensus on its nature and determination. It has rarely been studied in post-mortem examinations, despite increasing evidence of abnormalities from neuroimaging studies.

Aim To ascertain the feasibility of developing a national post-mortem ME/CFS tissue bank in the UK, to enhance studies on aetiology and pathogenesis, including cell and tissue abnormalities associated with the condition.

Methods The case study was carried out combining qualitative methods, ie, key informant interviews, focus group discussions with people with ME/CFS, and a workshop with experts in ME/CFS or in tissue banking.

Results and conclusions The study results suggest that the establishment of the post-mortem ME/CFS tissue bank is both desirable and feasible, and would be acceptable to the possible tissue donors, provided that some issues were explicitly addressed.

[CHESCA]

Muy interesante!!!!

Lástima que tengamos que morir para que se hagan más investigaciones y se sepa algo más de esta enfermedad.

Chesca