Recovery from Myalgic Encephalomyelitis/Chronic Fatigue syndrome developed after [SARS-CoV-2] vaccination: A case report, 2025, Kurotori et al

forestglip

forestglip

Moderator
Staff member
Recovery from Myalgic Encephalomyelitis/Chronic Fatigue syndrome developed after severe acute respiratory syndrome coronavirus 2 vaccination: A case report

Isaku Kurotori, Wataru Sasao, Masahiko Abe

[Line break added]

Background
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a neurological adverse effect after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations. However, clinicians do not recognize the condition well, and no case report has shown a full recovery.

Case Presentation
We present a 65-year-old Japanese female who experienced severe fatigue, postexertional malaise, orthostatic intolerance, and various symptoms after her third SARS-CoV-2 vaccination. Following thorough examinations and excluding other potential diagnoses, she met the diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

The symptoms persisted for 30 months and improved ultimately with comprehensive treatment and a self-management strategy, including pacing management, pharmacological treatments, and psychiatric interventions to support those struggling with the despair over the devastating symptoms.

Conclusion
This case report describes ME/CFS following the SARS-CoV-2 vaccination and its full recovery. It illustrates the importance of considering the differential diagnosis of psychiatric disorders and addressing the condition through psychiatric interventions. Our findings provide new insights into treating ME/CFS and the vaccination-related adverse effects.

Link | PDF (Psychiatry and Clinical Neurosciences Reports) [Open Access]
 
Line breaks added.
After excluding other potential diagnoses, she met the diagnostic criteria for ME/CFS.

While there is no evidenced-based radical treatment for ME/CFS and PEM, the most common treatment strategy aimed to relieve PEM, which balances energy and rests to reduce the frequency or severity of episodes of PEM, is called pacing.
Therefore, pacing with information about the diseases, education for self-management, and emotional support were incorporated. She was advised to engage in leisure activities and avoid overexerting herself with household chores or work.

She was encouraged not to dwell excessively on her symptoms, to take time for herself, and to find the path to recovery, under the clinician's guidance.

She was also required to report detailed daily activities every week for 2 months, while activity diaries were not introduced. Additionally, hochuekkito, a Japanese herbal (Kampo) medicine (7.5 g/day), and tandospirone (15 mg/day) were prescribed.
Click to expand...
The classic paternalistic approach of telling the patients how to behave and think.
Twelve months after the third vaccination, she restarted taking walks around the neighborhood and vegetable gardening at home, which she had been unable to do for a year.

Her symptoms gradually improved, and she said, “I was feeling rushed. I can see a clear sky now”.

Although her symptoms occasionally appeared, she developed self-management skills and began working every other day.

Fourteen months after the third vaccination, the patient experienced a new-onset headache that persisted for a month, leading to increased anxiety. The headache was alleviated after advising her to pace herself, offering supportive psychotherapy, and encouraging a commitment to recovery.

Her symptoms gradually improved with the coping strategy, allowing her to return to work just as before the third vaccination.

Thirty months after the third vaccination, her taste dysfunction finally improved, and all symptoms were entirely resolved. By the time this report was written, 6months had passed since her full recovery, with no signs of relapse or recurrence.
Click to expand...
If only I had not been committed to being sick, I would have already recovered!
Pacing is a physical therapy strategy that enables patients to increase or decrease their activity levels according to their daily condition, not to trigger PEM.25 Patients and clinicians collaboratively determine the activity limits that can be tolerated.2, 3
Click to expand...
No, pacing is not a therapy strategy. And there is no collaboration!
It is important to discuss and determine patients' tolerable activity limits through a mutual decision-making process.2, 3, 30
Click to expand...
Again, there is no mutual decision-making here. Stop trying to micro manage patients.
CONCLUSION
This case report highlights the occurrence of ME/CFS following the SARS-CoV-2 vaccination and details the patient's complete recovery. It emphasizes the importance of considering ME/CFS in the differential diagnosis among patients experiencing adverse effects of the SARS-CoV-2 vaccination. While the severity and conditions of each patient vary, our findings shed new light on the treatment of ME/CFS and the vaccination-related adverse effects. Psychiatrists can provide valuable interventions to help those struggling with devastating symptoms and the associated despair over the condition.
Click to expand...
There is nothing new here.

This appears to be a fortunate case of natural recovery over 2-3 years where the therapist believes that their divine insight and intervention, and the patients focus on recovery, made the recovery happen.
 
Snow Leopard said:
Yes, this very much sounds like a natural remission. It remains to be seen whether it is a long-term remission.
Click to expand...
Don't you think remission can be encouraged through appropriate support and treatment? That is commonplace in medicine and does not relegate a given condition to a biophysical nonentity, just one can get better more easily if the conditions are optimal. She was given both herbal and pharma interventions after all.
 
richie said:
Don't you think remission can be encouraged through appropriate support and treatment? That is commonplace in medicine and does not relegate a given condition to a biophysical nonentity, just one can get better more easily if the conditions are optimal. She was given both herbal and pharma interventions after all.
Click to expand...
What do you mean by «encouraged» and «treatment»?

I take encouraged to mean that there was something that caused an improvement, i.e. a treatment.

We don’t know of any effective treatments, so there is little reason to believe that any treatment has had a positive impact on her trajectory.

We don’t know how optimal pacing would affect the trajectory of ME/CFS, other than avoiding avoidable deterioration from harmful interventions or unsustainable activity levels. If that makes you more likely to improve is impossible to say.
 
promoted sth like that , enhanced, sped up. provided optimal conditions, removed obstacle to recovery. I think you will get the picture. The Japanese herbal is anti inflammatory and promotes mito function, the -one drug affects serotonin . Tilled the land abit to help recovery "grow" There are no double blinded trials etc admittedly but there is anecdote and each case is worthy of consideration imo. her interventions may havee helped her, What is ME anyway? A list of symptoms? Well as it is diagnosed that is the case. Maybe they hit on the bio underlying her symptoms. Might not help youn or me. I am not waiting around for double blined proofs. Any proof it was spontaneous and normal recovery?
 
richie said:
Don't you think remission can be encouraged through appropriate support and treatment? That is commonplace in medicine and does not relegate a given condition to a biophysical nonentity, just one can get better more easily if the conditions are optimal. She was given both herbal and pharma interventions after all.
Click to expand...
Science based treatment maybe, but evidence for those scientific mechanisms is lacking here.
 
Snow Leopard said:
Science based treatment maybe, but evidence for those scientific mechanisms is lacking here.
Click to expand...
Not all truths of medicine are scientifically proven so a useful therapy may not yet be deemed science based but it may be real in effect and have a sound but unknown mechanism. What was her condition? If inflammatory, many would say then not ME anyway, if sth to do with serotonin, possibly depression so some might say not to do with ME, mito stuff - well who knows? So we go back (as always up to now) to the sad fact that we are still dealing with a diagnosis by symptoms. She had some symptoms - enough for docs to deem her to have ME and she got better after some interventions. I can't prove prompter and no one can prove otherwise nor whether the effect if prompter was mainly biomechanistic or mainly psychological. I just note the meds used and maybe will try sth. For me nystatin killed 10 yrs of calf pain. No dbp trials to back that, but what do you do? I think it was prompter and "antifungal drug responsiveness syndrome" will do for me, while we await the science relevant to me and others, who have also responded to anti fungals, (should it ever be forthcoming with such small samples).
IMO science based medicine should demand a high standard of scientific proof for that label, but clinically effective medicine may be legitimately practiced while the data is still coming in or in rare disease never will. True, the plural of anecdote is not data, but absence of evidence is not evidence of absence. One truth needs the other imo.
My worry is that "ultra scientism" in dismissal of anecdotal biotherapies, can end up as the chief batman of "All in the headism", sharing a common dismissal of biophysical anecdote and leaving the field free to a science which is not yet there (and may not be relevant to all if the condition is an umbrella) and of course to the latest iteration of BPS. And they will have your services before you realise what's happened.
 
Snow Leopard said:
This is why for decades, medicine has demanded genuinely controlled trials. If that evidence doesn't exist - without known scientific mechanisms, it becomes pure speculation.
Click to expand...
To establish whether a therapy works whilst leaving the mechanism open to debate, but not to dismiss the possibility that a modality may work even if there is no scientific proof. I do not regret my nystatin on the ground that there was no trial/proof. I just, unlike some esp psychobehavioural beneficiaries do not try to foist it on others - but nystatin does not require ipso facto belief so I am not looking for converts just sharing with anyone it might benefit.
 
Last edited:
Utsikt said:
The classic paternalistic approach of telling the patients how to behave and think.

If only I had not been committed to being sick, I would have already recovered!

No, pacing is not a therapy strategy. And there is no collaboration!

Again, there is no mutual decision-making here. Stop trying to micro manage patients.

There is nothing new here.

This appears to be a fortunate case of natural recovery over 2-3 years where the therapist believes that their divine insight and intervention, and the patients focus on recovery, made the recovery happen.
Click to expand...

A natural recovery... or what's to say the patient pretended to be recovered to escape their paternalistic grips?

Reading stuff like this makes me cringe to maximum degree of cringe.
 
There are two levels of proof in play here. The first is establishing that A causes B, at least on a probabilistic basis. The second is establishing the mechanism by which that happens.

The psycho-behavioural advocates have established neither.
 
You must log in or register to reply here.
Back
Top Bottom