<p> Pathology of Chronic Fatigue Syndrome: Pilot Study of Four Autopsy Cases </p><p>DG O’Donovan1, 2, T Harrower3, S Cader2, LJ Findley2, C Shepherd4, A Chaudhuri2</p><p>1Addenbrooke’s Hospital Cambridge UK 2Queen’s Hospital Romford Essex UK 3Royal Devon & Exeter Hospitals UK 4Honorary Medical Advisor to ME Association UK</p><p>Chronic Fatigue Syndrome / Myalgic Encephalomyelitis is a disorder characterised by chronic exercise induced fatigue, cognitive dysfunction, sensory disturbances and often pain. The aetiology and pathogenesis are not understood.</p><p>We report the post mortem pathology of four cases of CFS diagnosed by specialists. The causes of death were all unnatural and included: suicidal overdose, renal failure due to lack of food and water, assisted suicide and probable poisoning.</p><p>Selected portions of tissue were made available by the various Coroners in the UK and with the assent of the persons in a qualifying relationship.</p><p>The cases were 1 male, and 3 female. Ages (years) M32, F32, F43 & F31.</p><p>One case showed a vast excess of corpora amylacea in spinal cord and brain of unknown significance but Polyglucosan Body Disease was not supported by clinicopathologial review. No ganglionitis was identified.</p><p>One case showed a marked dorsal root ganglionitis and two other cases showed mild excess of lymphocytes with nodules of nageotte in the dorsal root ganglia.</p><p>This raises the hypothesis that dysfunction of the sensory and probably also the autonomic nervous system may lead to abnormal neural activity eg hyperalgesia & allodynia rather than anaesthesia and may explain some of the symptoms of CFS / ME such as pain, hypotension, hyperacusis and photophobia. However, the syndrome may be heterogeneous.</p><p>Nevertheless, the precise relationship of fatigue, which may be either peripheral or central, to abnormalities in the peripheral nervous system (PNS) needs to be studied. </p><p>The differential diagnosis of ganglionitis should be investigated in CFS / ME patients hence Varicella Zoster, Lyme disease, HIV, Sjogren’s disease, paraneoplastic sensory ganglionopathy should be excluded by appropriate history and tests.</p><p>Thorough histopathological study of cases coming to autopsy may help to confirm or refute the hypothesis, that CFS is a disease process, and whether the symptomatology may be explained by inflammation of the sensory and autonomic divisions of the PNS. A specific CFS / ME brain and tissue bank in the UK is proposed.</p><p>DGOD 26/04/2018 Platform Presentation Bond University Brisbane Australia 3rd 4th December 2010</p>