Friday, May 6, 2011

Abnormal test results in ME/CFS


Laboratory abnormalities in ME/CFS include abnormal SIgA; weakly positive IgG3 (linked to gastrointestinal tract disorders); positive IgM; increased T4:T8 ratio (which always corresponds with disease severity); very low numbers of NK cells, with decreased cytolytic activity; low levels of circulating immune complexes (two-thirds of ME patients have insoluble circulating immune complexes); autoantibodies (especially antinuclear and smooth muscle); a particular HLA antigen expression; PCR evidence of abnormalities in muscle; a positive water loading test with erratic arginine-vasopressin release; a significant prolactin release in response to a single buspirone challenge; positive SPECT scans (which show reduced blood flow through the brain stem in a particular pattern not found in any other illness or disease process apart from ME/CFS – QJMed 1995:88:767-773); abnormal fMRI scans; abnormal EEG (80% of ME patients show prolonged jitter); a positive VP1 test; positive mast cells; low pancreatic exocrine function; low copper response test; anomalies in trace element metabolism, especially low red blood cell levels of magnesium, zinc and chromium;  low potassium levels; low peripheral oxygenation levels, with poor perfusion and pulsatilities, and increased hsCRP. According to Peter Behan, Professor of Neurological Sciences at the University of Glasgow, as these abnormalities have been shown to occur with such regularity, if they are present and if the clinical picture is right, then a firm diagnosis of ME can be made.  In 2001, evidence was presented by SCM Richards et al (including Anthony Cleare who co-authors papers on ME/CFS with Simon Wessely) at the British Society of Rheumatologists' Conference in Edinburgh showing that 53% of ME/CFS patients were excreting in their urine significant levels of creatine and other muscle-related metabolites including choline and glycine, indicating on-going muscle damage, as creatine has been shown to be a sensitive marker of muscle inflammation and is objective evidence of muscle pathology.