Release from ME Association:

"Monday, September 19, 2005

Differential diagnosis of chronic fatigue plus shortness of breath

The symptom of chronic fatigue can be a prominent feature of many different illnesses - both physical and psychiatric.

In the case of someone presenting with a possible diagnosis of ME/CFS, the decision on how far to investigate has to be made on the clinical history and examination findings. In the case of patients who have a symptom such as joint pain which is consistent with ME/CFS, but more prominent than would normally be expected, then further investigations to rule out a rheumatic cause (eg lupus/SLE) would obviously be necessary.

In the case of chronic fatigue plus breathlessness the same logic applies, and one condition that tends to be missed here is sarcoidosis. Another is pulmonary hypertension, and doctors have just been warned yet again to consider this serious form of hypertension in patients who present with symptoms that can include:

breathlessness
fatigue
palpitations
chest pain
depression

Although uncommon, and known to affect only about 4,000 people in the UK, doctors estimate that a further 4,000 people with pulmonary hypertension remain undiagnosed or misdiagnosed. The diagnosis is also more common in people (especially women aged 18 - 30) with a history of using appetite suppressants, or the use of illegal drugs such as cocaine.

Source: Presentation at the European Cardiology Society Conference, September 2005

Further information: A detailed list of conditions which need to be considered in the differential diagnosis of ME/CFS can be found in Table 2 (page 11) of the clinical assessment section of the new (May 2005) edition of 'ME/CFS/PVFS - An exploration of the key clinical issues' (MEA publication). Information on investigations which are always required; are only appropriate in certain circumstances; and those which are not recommended can be found in Section 6:6 on pages 10 - 11.


Dr Charles Shepherd
Medical Adviser, ME Association"

I've just updated my diary again. You can read my latest entry here!

Claire
sleepydust.net