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'Overlapping' Syndromes
Hallmarks of the syndromes include non-nociceptive
pain, fatigue, memory difficulties, and dysfunction of visceral organs, Clauw, 2002. Is FM a disease of the brain
?,schweinhardt.etal07.txt. The following syndromes are regarded as overlapping CFS/ME: Fibromyalgia (FM), Post-Polio Syndrome (PPS), Gulf War Syndrome (GWS), Multiple Chemical Sensitivity (MCS), Irritable Bowel Syndrome (IBS), temporomandibular disorder (TMD), Lupus (SLE) and Interstitial Cystitis (IC). The coexistence of FM and TMD with MMP is high, leblebici.etal06.txt. Suggestions for an extension of the Whiplash is definitely also an overlapping
syndrome, but it is not possible to contain the many Whiplash research papers
within the limits of the present CFS/ME-website. A 2002-paper which
discuss Whiplash/FM from a psychological point of view, Ferrari, 2002. Also overlapping are "Silicone
Related Symptoms",
Brown et al., 2002, and endometriosis, Sinaii et al., 2002. The features shared by CFS and Multiple
Sclerosis, MS are listed by Dr. Poser, CAA, Poser, 2000, and by Dr.
Macintyre, information, Macintyre, 2002. Lyme disease can be mistaken for
CFS, shor06.txt. More seldom is mentioned vulvodynia, arnold.etal06.txt. Studies on Overlap
Many respected researchers now
believe the syndromes share common pathophysiological mechanisms [i.e.
the same underlying disease processes]. A study of overlap between CFS,
FM and temporomandibular disorder (TMD),
Aaron et al., 2000 (txt),
Aaron et al., 2000 (pdf), and Ta et
al., 2002. Dr. Jason's group studied the degree of overlap between CFS,
FM and MCS,
Jason et al., 2000, and, Taylor et al., 2001. A thorough
review from Dr. Klimas group on the overlap between FM and other
syndromes,
Patarca-Montero, 2001, and Dr. Buchwald's group
found more overlap between CFS and FM than expected, Sullivan et al., 2002. Overlap between FM and overactive bladder
syndrome, soyupek.etal07.txt. By studying disabilities,
Belgian researchers suggest that CFS
and FM are aspects of the same disease, nijs.etal.04.txt, nijs.etal04.pdf. A review of muscular pain in CFS,
meeus.etal06.txt, meeus.etal.06.txt, meeus.etal06.pdf. More information on pain in
CFS, meeus.nijs06.txt. CFS and rheumatic diseases overlap in terms of
salivary gland damage, Woo
et al., 2000. FM overlaps with rheumatic diseases, in this
case Systemic Lupus, akkasilpa.etal05.txt. Fatigue is a symptom shared by all
rheumatic diseases, zautra.etal06.txt. FM
and migraine share the presence of increased glutamate in
cerebrospinal fluid, peres.etal04.txt. In terms of HPA-deficiency rheumatic diseases
overlap with CFS, johnson.etal06.txt, and
TMD with FM, balasubramaniam.etal07.txt. From a psychiatric point of view overlapping
symptoms imply common, but unexplained mechanisms of disease, as in
'unexplained clinical conditions',
Aaron & Buchwald, 2001. The
'UK-psychiatric-approach' to the syndromes, meaning "functional
somatic",
Nimnuan et al., 2001 (abstr), Nimnuan et al., 2001 (paper). A study by
Dr. Jason documented co-existence of CFS, FM and psychiatric disease, but
referred to it simply as comorbidity,
Jason et al., 2001. One review found co-morbidity of IBS and
other syndromes, and suggested a psychological explanation, Whitehead et al., 2002. A
population-based Swedish study, kato.etal06.txt,
kato.etal06.pdf. FM women have increased
risk of metabolic syndrome, loevinger.etal06.txt.
The Single Syndrome Hypothesis
All the above evidence has led to the hypothesis of One Single Syndrome, Ciccone & Natelson, 2003 (short), Ciccone & Natelson, 2003, Ciccone & Natelson, 2003 (pdf). The idea is supported by the finding of common cytokine abnormalities, vandemerwe.etal03.txt. FM and SLE may have involvement of N-methyl-d-aspartate (NMDA) and neurokinin receptor systems in common, staud06.txt. The Unifying Concept of Central Sensitivity Syndromes, yunus07.txt, and others, meeus.nijs06.txt.
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