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CFS: A Case Report .. Diagnosing and Treatment Challenges and the Possibility of Jarisch–Herxheimer Reactions..., 2021, Straub and Powers

Discussion in 'ME/CFS research' started by Sly Saint, Nov 11, 2021.

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  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    Chronic Fatigue Syndrome: A Case Report Highlighting Diagnosing and Treatment Challenges and the Possibility of Jarisch–Herxheimer Reactions if High Infectious Loads Are Present
    Straub and Powers
    Abstract
    Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex multi-system disease with no cure and no FDA-approved treatment. Approximately 25% of patients are house or bedbound, and some are so severe in function that they require tube-feeding and are unable to tolerate light, sound, and human touch.
    The overall goal of this case report was to
    (1) describe how past events (e.g., chronic sinusitis, amenorrhea, tick bites, congenital neutropenia, psychogenic polydipsia, food intolerances, and hypothyroidism) may have contributed to the development of severe ME/CFS in a single patient, and
    (2) the extensive medical interventions that the patient has pursued in an attempt to recover, which enabled her to return to graduate school after becoming bedridden with ME/CFS 4.5 years prior.

    This paper aims to increase awareness of the harsh reality of ME/CFS and the potential complications following initiation of any level of intervention, some of which may be necessary for long-term healing.
    Treatments may induce severe paradoxical reactions (Jarisch–Herxheimer reaction) if high infectious loads are present. It is our hope that sharing this case will improve research and treatment options for ME/CFS.

    https://www.mdpi.com/2227-9032/9/11/1537
     
    Sly Saint, Nov 11, 2021
    #1
    Peter Trewhitt, oldtimer, Hutan and 2 others like this.
  2. Trish

    Trish Moderator Staff Member

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    I don't understand why two people from a physical therapy department and who were clearly not the patient's physician came to write this paper, unless one of them is the patient.

    I have read through the article, and it's clear the woman suffered from a lot of symptoms for many years from childhood, and had a huge number of investigations and treatments, including antibiotics, thyroid treatment, dietary changes, herbs and psychological therapy. It is therefore impossible to tell which, if any, of the treatments were relevant to her 4 years of severe ME.

    I think this sentence is probably the most significant:

    And this one, which means I'm puzzled why the article title gives so much prominence to Herx reactions:

    It seems to me, with such a huge range of treatments apparently happening concurrently, it would be impossible to tell whether it's herx, side effects of the drug or PEM.

    I conclude that this anecdote does not advance understanding of ME/CFS treatments, but of course I'm glad the patient is much better and wish her well.
     
    Last edited: Nov 11, 2021
    Trish, Nov 11, 2021
    #2
    Snow Leopard, Peter Trewhitt, cfsandmore and 9 others like this.

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