Identifying subgroups in the chronic fatigue syndrome

The chronic fatigue syndrome affecting a large patient population with different symptoms such as sleeplessness, tiredness and pain is examined in our center. Patients can be selected using different criteria, Fukuda's criteria being the most recommended nowadays and Holmes's criteria the earlier more restricted criteria. We evaluated in 40 patients(32 women, 8 men; mean age 43.0 ± 7.8 years, mean ± SD fulfilling Fukuda's criteria for tender points' pain pressure sensitivity and infrared thermography emission. By considering Holmes' (H) criteria for the chronic fatigue syndrome and fibromyalgia (F) criteria, we subdivided the population into 4 subgroups: (F+ H+, F+ H-, F- H+, F- H-). Fibromyalgia patients not fulfilling Holmes' criteria (F+ H-) were statistically different for pain pressure threshold (p = 0.03) from the other patients. Moreover, this first group showed a normal infrared thermographic emission considering pain, where the other patients showed a rather abnormal vasomotor reaction.