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Return to physical activity may prevent post-mononucleosis fatigue

מתוך medicontext.co.il

LONDON (Reuters Health) – Physical deconditioning contributes to prolonged fatigue after a bout of infectious mononucleosis, British investigators report. They suggest that beginning a graded physical activity program soon after recovery may prevent the onset of empirically defined chronic fatigue syndrome (CFS).

Dr. Peter D. White, of St. Bartholomew's Hospital in London, and associates previously reported that infectious mononucleosis, or the agents responsible, may be an aetiological factor in CFS. In the current prospective study, reported in The Lancet for December 8, 118 subjects were diagnosed with infectious mononucleosis and 127 with ordinary upper-respiratory tract infections.

CFS was defined empirically as abnormal physical fatigue for at least 2 weeks, along with two of the following: hypersomnia, poor concentration, retardation, irritability, or anhedonia. Presence of any psychiatric condition except phobias, non-specific somatoform disorder, and neurasthenia excluded a diagnosis of CFS.

The most reliable predictors of empirically defined CFS were a positive Monospot test at onset and lower physical fitness. Enlarged cervical glands were associated with CFS at 1 month and 2 months. Time spent in bed at onset predicted CFS at 2 months. A previous psychiatric history or mood disorder had no significant predictive influence on CFS.

Several investigated variables were unrelated to empirically defined CFS, including insidious onset, number of physical symptoms, throat inflammation or previous tonsillectomy, antibiotics or other medication, or number of friends or confidants.

The results varied when CFS was defined according to Oxford criteria or the US Centers for Disease Control and Prevention criteria, which the authors describe as "consensually defined." Using these two criteria, a mixture of factors that predicted empirical CFS or mood disorders are involved, particularly pre-onset primary-care attendance and previous mood disorders.

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