Chronic Fatigue Syndrome Diagnosed in Younger Children

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By Will Boggs, MD

NEW YORK (Reuters Health) May 16 - Chronic fatigue syndrome (CFS) can be diagnosed in children aged 11 years and younger, according to a report in the May issue of the Archives of Disease in Childhood.

"CFS/ME (myalgic encephalomyelitis) exists in these young children," Dr. Esther Crawley told Reuters Health. "It is important that physicians are aware of this, because the prognosis is good if physicians make a diagnosis."

Dr. Crawley from the Centre for Child and Adolescent Health, Cotham Hill, UK and Dr. S. Davies from Southmead Hospital, Bristol, UK describe 32 younger children who presented with CFS while at primary school and compared them to children aged 12 years or older who presented with CFS during the same time frame.

Three of the younger children were under 5 years old, the report indicates, and the youngest child with CFS was 2 years old. There were more female (68%) than male children with CFS.

Children under age 12 were severely affected, the authors report, with a mean school attendance of just over 40% and a mean Chalder fatigue score of 8.3 on a scale where maximum fatigue is 11.

All patients had post-exertional malaise, and most had unrefreshing sleep (96%) and subjective memory impairment (80%).

Fatigue, anxiety, pain, functional disability, number of symptoms, time at school, and time to assessment did not differ significantly between the younger and older patient groups, the researchers note.

Twenty-four of 26 younger children with complete symptom lists would have met the stricter adult criteria for CFS published by the Centers for Disease Control, the investigators say.

"Some of these children present with chronic headache or chronic abdominal pain," Dr. Crawley explained. "If physicians think about fatigue, they may be able to make the correct diagnosis earlier and help these children sooner."

"The epidemiology suggests that only 1 in 10 get a diagnosis and we are looking at why this is," Dr. Crawley added. "We are also looking at factors that predict outcome."

Arch Dis Child 2008;93:419-422.
Reuters Health Information © 2008 Reuters Ltd.