Twisk Frank
ME-de-Patiënten Foundation, Zonnedauw 15, 1906 HB Limmen, The Netherlands.
Diagnostics (Basel). 2018 Dec 20;9(1):1. doi: 10.3390/diagnostics9010001.
Myalgic encephalomyelitis (ME) is a neuromuscular disease with two distinctive types of symptoms (muscle fatigability or prolonged muscle weakness after minor exertion and symptoms related to neurological disturbance, especially of sensory, cognitive, and autonomic functions) and variable involvement of other bodily systems. Chronic fatigue syndrome (CFS), introduced in 1988 and re-specified in 1994, is defined as (unexplained) chronic fatigue accompanied by at least four out of eight listed (ill-defined) symptoms. Although ME and CFS are two distinct clinical entities (with partial overlap), CFS overshadowed ME for decades. In 2011, a panel of experts recommended abandoning the label CFS and its definition and proposed a new definition of ME: the International Consensus Criteria for ME (ME-ICC). In addition to post-exertional neuroimmune exhaustion (PENE), a mandatory feature, a patient must experience at least three symptoms related to neurological impairments; at least three symptoms related to immune, gastro-intestinal, and genitourinary impairments; and at least one symptom related to energy production or transportation impairments to meet the diagnosis of ME-ICC. A comparison between the original definition of ME and the ME-ICC shows that there are some crucial differences between ME and ME-ICC. Muscle fatigability, or long-lasting post-exertional muscle weakness, is the hallmark feature of ME, while this symptom is facultative for the diagnosis under the ME-ICC. PENE, an abstract notion that is very different from post-exertional muscle weakness, is the hallmark feature of the ME-ICC but is not required for the diagnosis of ME. The diagnosis of ME requires only two type of symptoms (post-exertional muscle weakness and neurological dysfunction), but a patient has to experience at least eight symptoms to meet the diagnosis according to the ME-ICC. Autonomic, sensory, and cognitive dysfunction, mandatory for the diagnosis of ME, are not compulsory to meet the ME-ICC subcriteria for 'neurological impairments'. In conclusion, the diagnostic criteria for ME and of the ME-ICC define two different patient groups. Thus, the definitions of ME and ME-ICC are not interchangeable.
肌痛性脑脊髓炎（ME）是一种神经肌肉疾病，有两种不同类型的症状（肌肉易疲劳或轻微运动后肌肉长期无力，以及与神经功能紊乱相关的症状，尤其是感觉、认知和自主神经功能方面），且其他身体系统受累情况各异。慢性疲劳综合征（CFS）于1988年提出，并在1994年重新定义，定义为（不明原因的）慢性疲劳，并伴有列出的八项（定义不明确的）症状中的至少四项。尽管ME和CFS是两种不同的临床实体（有部分重叠），但几十年来CFS掩盖了ME。2011年，一个专家小组建议摒弃CFS这一名称及其定义，并提出了ME的新定义：国际肌痛性脑脊髓炎共识标准（ME-ICC）。除了运动后神经免疫耗竭（PENE）这一必备特征外，患者必须经历至少三种与神经功能损害相关的症状；至少三种与免疫、胃肠道和泌尿生殖系统损害相关的症状；以及至少一种与能量产生或运输损害相关的症状，才能符合ME-ICC的诊断标准。ME的原始定义与ME-ICC之间的比较表明，ME和ME-ICC之间存在一些关键差异。肌肉易疲劳或运动后长期肌肉无力是ME的标志性特征，而在ME-ICC下该症状对诊断而言是可选的。PENE是一个与运动后肌肉无力非常不同的抽象概念，是ME-ICC的标志性特征，但ME的诊断并不需要它。ME的诊断仅需要两种症状（运动后肌肉无力和神经功能障碍），但根据ME-ICC，患者必须经历至少八种症状才能符合诊断。自主神经、感觉和认知功能障碍是ME诊断的必备条件，但不符合ME-ICC中“神经功能损害”的子标准。总之，ME和ME-ICC的诊断标准定义了两个不同的患者群体。因此，ME和ME-ICC的定义不可互换。
