Guest guest Posted November 14, 2001 Report Share Posted November 14, 2001 Mark, Thanks for your thoughts on hyperpigmentation. Maybe it just isn't an extreme enough situation for that to show up. Concerning aldosterone, I haven't done much studying on that, because I had been under the impression that it was found at normal levels in PWCs. But maybe not. Here are a couple of abstracts you might find interesting: Clin Auton Res 1997 Aug;7(4):185-90 Pathogenesis and management of delayed orthostatic hypotension in patients with chronic fatigue syndrome. De Lorenzo F, Hargreaves J, Kakkar VV. Thrombosis Research Institute, London, UK. The relationship between orthostatic hypotension and chronic fatigue syndrome (CFS) has been reported previously. To study the pathogenesis and management of delayed orthostatic hypotension in patients with CFS, a case comparison study with follow-up of 8 weeks has been designed. A group of 78 patients with CFS (mean age 40 years; 49% men and 51% women), who fulfilled the Centre for Disease Control and Prevention criteria were studied. There were 38 healthy controls (mean age 43 years; 47% men and 53% women). At entry to the study each subject underwent an upright tilt-table test, and clinical and laboratory evaluation. Patients with orthostatic hypotension were offered therapy with sodium chloride (1200 mg) in a sustained-release formulation for 3 weeks, prior to resubmission to the tilt-table testing, and clinical and laboratory evaluation. An abnormal response to upright tilt was observed in 22 of 78 patients with CFS. After sodium chloride therapy for 8 weeks, tilt-table testing was repeated on the 22 patients with an abnormal response at baseline. Of these 22 patients, 10 redeveloped orthostatic hypotension, while 11 did not show an abnormal response to the test and reported an improvement of CFS symptoms. However, those CFS patients who again developed an abnormal response to tilt-test had a significantly reduced plasma renin activity (0.79 pmol/ml per h) compared both with healthy controls (1.29 pmol/ml per h) and with those 11 chronic fatigue patients (1.0 pmol/ml per h) who improved after sodium chloride therapy (p = 0.04). In conclusion, in our study CFS patients who did not respond to sodium chloride therapy were found to have low plasma renin activity. In these patients an abnormal renin-angiotensin-aldosterone system could explain the pathogenesis of orthostatic hypotension and the abnormal response to treatment. [Chronic fatigue syndrome, a case of high anti-HHV-6 antibody titer and one associated with primary hyperaldosteronism.] [Article in Japanese] Kato Y, Kamijima S, Kashiwagi A, Oguri T. Second Department of Internal Medicine, Aichi Medical College. Two cases of chronic fatigue syndrome (CFS) were reported which were suggestive for the study of the etiology and a cure for CFS. Case 1: A 31-year-old woman was admitted for chronic fatigue syndrome. Examination revealed a high titer of anti HHV-6 antigen of x2560 and an increased percentage of suppressor T lymphocytes in the peripheral blood. HHV-6 was speculated to be reactivated and stimulating the immune system in CFS. Case 2: A 46-year-old woman suffering from CFS had been in remission for 6 years. She was admitted for hypertension associated with right adrenal adenoma and hyperaldosteronism. After right adrenalectomy, there was a recurrence of high fever and other CFS symptoms. It was suggested that CFS symptoms may be ameliorated by aldosterone. Rich Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 15, 2001 Report Share Posted November 15, 2001 Rich, Thanks for doing the leg work on those studies. How exactly the remission could be related to aldosterone I don't know in that Japanese study. Very curious. Hmmm. Mark > Mark, > > Thanks for your thoughts on hyperpigmentation. Maybe it just isn't an > extreme enough situation for that to show up. > > Concerning aldosterone, I haven't done much studying on that, because > I had been under the impression that it was found at normal levels in > PWCs. But maybe not. Here are a couple of abstracts you might find > interesting: > > Clin Auton Res 1997 Aug;7(4):185-90 > > Pathogenesis and management of delayed orthostatic hypotension in > patients with chronic fatigue syndrome. > > De Lorenzo F, Hargreaves J, Kakkar VV. > > Thrombosis Research Institute, London, UK. > > The relationship between orthostatic hypotension and chronic fatigue > syndrome (CFS) has been reported previously. To study the pathogenesis > and management of delayed orthostatic hypotension in patients with > CFS, a case comparison study with follow-up of 8 weeks has been > designed. A group of 78 patients with CFS (mean age 40 years; 49% men > and 51% women), who fulfilled the Centre for Disease Control and > Prevention criteria were studied. There were 38 healthy controls (mean > age 43 years; 47% men and 53% women). At entry to the study each > subject underwent an upright tilt-table test, and clinical and > laboratory evaluation. Patients with orthostatic hypotension were > offered therapy with sodium chloride (1200 mg) in a sustained- release > formulation for 3 weeks, prior to resubmission to the tilt-table > testing, and clinical and laboratory evaluation. An abnormal response > to upright tilt was observed in 22 of 78 patients with CFS. After > sodium chloride therapy for 8 weeks, tilt-table testing was repeated > on the 22 patients with an abnormal response at baseline. Of these 22 > patients, 10 redeveloped orthostatic hypotension, while > 11 did not show an abnormal response to the test and reported an > improvement of CFS symptoms. However, those CFS patients who again > developed an abnormal response to tilt-test had a significantly > reduced plasma renin activity (0.79 pmol/ml per h) compared > both with healthy controls (1.29 pmol/ml per h) and with those 11 > chronic fatigue patients (1.0 pmol/ml per h) who improved after sodium > chloride therapy (p = 0.04). In conclusion, in our study CFS patients > who did not respond to sodium chloride therapy were found to > have low plasma renin activity. In these patients an abnormal > renin-angiotensin-aldosterone system could explain the pathogenesis of > orthostatic hypotension and the abnormal response to treatment. > > > [Chronic fatigue syndrome, a case of high anti-HHV-6 antibody titer > and one associated with primary hyperaldosteronism.] > > [Article in Japanese] > > Kato Y, Kamijima S, Kashiwagi A, Oguri T. > > Second Department of Internal Medicine, Aichi Medical College. > > Two cases of chronic fatigue syndrome (CFS) were reported which were > suggestive for the study of the etiology and a cure for CFS. Case 1: A > 31-year-old woman was admitted for chronic fatigue syndrome. > Examination revealed a high titer of anti HHV-6 antigen of x2560 > and an increased percentage of suppressor T lymphocytes in the > peripheral blood. HHV-6 was speculated to be reactivated and > stimulating the immune system in CFS. Case 2: A 46-year-old woman > suffering from CFS had been in remission for 6 years. She was > admitted for hypertension associated with right adrenal adenoma and > hyperaldosteronism. After right adrenalectomy, there was a recurrence > of high fever and other CFS symptoms. It was suggested that CFS > symptoms may be ameliorated by aldosterone. > > Rich Quote Link to comment Share on other sites More sharing options...
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