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Enteroviruses & postviral fatigue syndrome

  [ 132 votes ]   [ Discuss This Article ] • January 3, 1993

Postviral fatigue syndrome (PFS) occurs both in epidemics and
sporadically. Many of the original epidemics were related to
poliomyelitis outbreaks which either preceded or followed
them. The core clinical symptoms are always the same: severe
fatigue made worse by exercise, myalgia, night sweats,
atypical depression and excessive sleep. The other common
symptoms include dysequilibrium disorders and irritable bowel
syndrome. We have detected enteroviral genome sequences in
muscle biopsies from cases of PFS, using specific enteroviral
oligonucleotide primers in the polymerase chain reaction
(PCR). In addition, whole virus particles can be demonstrated
in PCR-positive muscle, using solid-phase immuno-electron
microscopy. An increase in the number and size of muscle
mitochondria was found in 70% of PFS cases, suggesting an
abnormality in metabolic function. Evidence of hypothalamic
dysfunction was present, particularly involving
5-hydroxytryptamine metabolism. A putative model of PFS, based
on persistent enteroviral infection in laboratory mice,
revealed resolving inflammatory lesions in muscle with,
however, a marked increase in the production of certain
cytokines in the brain. This model may help to explain the
pathogenesis of PFS.

Behan PO, Behan WM, Gow JW, Cavanagh H, Gillespie S

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