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Evaluation of four clinical laboratory parameters for the diagnosis of myalgic encephalomyelitis.

ABSTRACT: BACKGROUND:Myalgic encephalomyelitis (ME) is a complex and debilitating disease that often initially presents with flu-like symptoms, accompanied by incapacitating fatigue. Currently, there are no objective biomarkers or laboratory tests that can be used to unequivocally diagnosis ME; therefore, a diagnosis is made when a patient meets series of a costly and subjective inclusion and exclusion criteria. The purpose of the present study was to evaluate the utility of four clinical parameters in diagnosing ME. METHODS:In the present study, we utilized logistic regression and classification and regression tree analysis to conduct a retrospective investigation of four clinical laboratory in 140 ME cases and 140 healthy controls. RESULTS:Correlations between the covariates ranged between [-?0.26, 0.61]. The best model included the serum levels of the soluble form of CD14 (sCD14), serum levels of prostaglandin E2 (PGE2), and serum levels of interleukin 8, with coefficients 0.002, 0.249, and 0.005, respectively, and p-values of 3?×?10-7, 1?×?10-5, and 3?×?10-3, respectively. CONCLUSIONS:Our findings show that these parameters may help physicians in their diagnosis of ME and may additionally shed light on the pathophysiology of this disease.

SUBMITTER: De Meirleir KL

PROVIDER: S-EPMC6249861 | biostudies-other | 2018 Nov

REPOSITORIES: biostudies-other

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Evaluation of four clinical laboratory parameters for the diagnosis of myalgic encephalomyelitis.

De Meirleir Kenny L KL Mijatovic Tatjana T Subramanian Krishnamurthy K Schlauch Karen A KA Lombardi Vincent C VC

Journal of translational medicine 20181121 1

<h4>Background</h4>Myalgic encephalomyelitis (ME) is a complex and debilitating disease that often initially presents with flu-like symptoms, accompanied by incapacitating fatigue. Currently, there are no objective biomarkers or laboratory tests that can be used to unequivocally diagnosis ME; therefore, a diagnosis is made when a patient meets series of a costly and subjective inclusion and exclusion criteria. The purpose of the present study was to evaluate the utility of four clinical paramete ...[more]

PMID: 30463572

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Project description:ObjectiveTo assess five physical signs to see whether they can assist in the screening of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and potentially lead to quicker treatment.MethodsThis was a diagnostic accuracy study with inter-rater agreement assessment. Participants recruited from two National Health Service hospitals, local CFS/ME support groups and the community were examined by three practitioners on the same day in a randomised order. Two allied health professionals (AHPs) performed independent examinations of physical signs including: postural/mechanical disturbances of the thoracic spine, breast varicosities, tender Perrin's point, tender coeliac plexus and dampened cranial flow. A physician conducted a standard clinical neurological and rheumatological assessment while looking for patterns of illness behaviour. Each examination lasted approximately 20?min.ResultsNinety-four participants were assessed, 52 patients with CFS/ME and 42 non-CFS/ME controls, aged 18-60. Cohen's kappa revealed that agreement between the AHPs was substantial for presence of the tender coeliac plexus (?=0.65, p<0.001) and moderate for postural/mechanical disturbance of the thoracic spine (?=0.57, p<0.001) and Perrin's point (?=0.56, p<0.001). A McNemar's test found no statistically significant bias in the diagnosis by the experienced AHP relative to actual diagnosis (p=1.0) and a marginally non-significant bias by the newly trained AHP (p=0.052). There was, however, a significant bias in the diagnosis made by the physician relative to actual diagnosis (p<0.001), indicating poor diagnostic utility of the clinical neurological and rheumatological assessment.ConclusionsUsing the physical signs appears to improve the accuracy of identifying people with CFS/ME and shows agreement with current diagnostic techniques. However, the present study concludes that only two of these may be needed. Examining for physical signs is both quick and simple for the AHP and may be used as an efficient screening tool for CFS/ME. This is a small single-centre study, and therefore, further validation in other centres and larger populations is needed.

Dataset Information

Evaluation of four clinical laboratory parameters for the diagnosis of myalgic encephalomyelitis.

Publications

Evaluation of four clinical laboratory parameters for the diagnosis of myalgic encephalomyelitis.

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