"It is likely that this illness can be triggered by a heterogeneous group of forces and circumstances." Prof A. Komaroff MD, 1990 1/ #pwME #MyalgicE #MEhistory
"An attractive model is: immune dysfunction is produced as a consequence of exogenous lymphotropic viruses, environmental toxins, stress or depression; the immune dysfunction leads to the reactivation of dormant, latent infectious agents;" Prof A. Komaroff MD, 1990 2/ #MEhistory
"...the reactivated infectious agents produce morbidity through cytodestructive action; the immunologic response to exogenous + endogenous agents, such as the elaboration of various cytokines, may also produce some of the morbidity of the illness..." Prof A. Komaroff MD, 1990 3/
"Over the past 100 years, the medical literature has included descriptions of several ill-defined clinical syndromes that produce chronic fatigue: neurasthenia, postviral fatigue syndrome,chronic mononucleosis, severe chronic active EBV infection,myalgic encephalomyelitis..."4/
"... and more recently, chronic fatigue syndrome. In recent years, there has been much speculation that these syndromes may be secondary to chronic viral infection." 5/
"The syndromes go by different names, but share so many clinical and laboratory features that some believe they may be the same illness: that is, they may share a final common pathogenetic pathway." 6/
"In my judgement, the similarities in the clinical descriptions of patients in all these groups are more impressive than the differences." 7/
"This acute illness never seems to fully resolve. While its character may change over time, and its severity may vary, a state of chronic ill health ensues." 8/
"In our experience, two particularly remarkable findings are post-exertional malaise and recurrent, often drenching night sweats." (NB Night sweats are often mentioned in the literature but I think this might be the earliest reference to PEM I've seen. Pls correct me if not.) 9/
"Most patients seeking medical care for 'chronic fatigue' probably are suffering from a primary affective disorder (depression and/or anxiety), and probably 'do not' have CFS." (My italics) 10/
"At the core of CFS, I suspect, is an immunologic disturbance that allows reactivation of latent and ineradicable infectious agents, particularly viruses. The reactivation of these viruses may only be an epiphenomenon." 11/
"However, I feel it is more likely that, once secondarily reactivated, these viruses contribute to the morbidity of CFS - directly, by damaging certain tissues... and indirectly, by eliciting an ongoing immunologic response." 12/
"In particular, the elaboration of various cytokines (eg interferon-alpha and interleukin-2) as part of this ongoing immunologic war may produce many of the symptoms of CFS." 13/
"Whatever the course, the symptoms of CFS lead to some degree of debility in every patient." 14/
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