There is much about fibromyalgia, POTS, and myalgic encephalomyelitis that we do not understand, including the frequent link with major stressors earlier in life in many but certainly not all patients. The potential role of a viral vector persisting within select nerve cells or microglia3 after an infection in some patients with chronic fatigue and other symptoms cannot be totally dismissed as a pathogenic contributor, but at present we cannot test or treat for this. Many patients with chronic systemic inflammatory disorders report similar symptoms, but this does not imply that all patients with SLE and related syndromes have chronic viral infections any more than implying that patients with POTS who share these symptoms have SLE. The fact that rare patients with Sjögren syndrome have been reported to have a sensory ganglionopathy or marked dysautonomia should not imply that patients with any symptoms suggesting autonomic dysregulation should be tested for the presence of nonspecific autoantibodies such as SSA (associated with, but not specific to the diagnosis of Sjögren). That many of these patients display features of autonomic dysfunction is of interest given our burgeoning understanding of the interplay between vagal nerve activity and inflammation,4 but our understanding of this at present is far too limited to do any more than recognize intriguing relationships and possible therapeutic pathways. https://www.ccjm.org/content/90/7/395
I don't understand why someone discussing whether various conditions are autoimmune thinks it's OK to throw this into the mix without providing any evidence. my bolding.
