Journal Club:

Article: Bell DS, Jordan K, Robinson M. Thirteen-Year Follow-Up of Children and Adolescents With Chronic Fatigue Syndrome. Pediatrics Vol. 107 No. 5 May 2001, pp. 994-998.

Review by David S. Bell, MD, FAAP

Published in Lyndonville News, May 2001

Summary: This article seeks to describe the educational, social, and symptomatic outcome of a group of 35 children and adolescents with CFS 13 years after illness onset. The children were part of a cluster of CFS in the Lyndonville area. Of the participants, 68.6% were female; average age at illness onset was 12.1 years; and only 22.9% had an acute onset of symptoms. No participant received an alternative medical diagnosis that could have explained the symptom complex between illness onset and follow-up. Thirteen participants (37.1%) considered themselves resolved of illness at follow-up; 15 participants (42.9%) considered themselves well but not resolved; 4 (11.4%) considered themselves chronically ill; and 3 (8.6%) considered themselves more ill than during the early years of illness. Correlation with the Medical Outcomes Study Short Form Health Survey was good for current level of symptoms and degree of recovery. Eight participants (22.9%) missed >2 years of school, and 5 of these were still ill at follow-up. Amount of school missed correlated with both illness severity at follow-up and perceived social impact of the illness.

Discussion and Opinion: It seems a little strange to comment on our own study. It can be argued that Mary and I are a little biased about this study. Notwithstanding, this study is both good news and bad news. The good news is that 80% of the young people have grown up and are leading normal lives, and consider themselves either well or almost well. The bad news is that 20% are still really sick thirteen years later. Another bit of bad news is that of those doing well, nearly half still have prominent symptoms suggesting that CFS is still present, although in mild form. The fact that these kids (now adults) are doing well is a testimony to the tremendous strength of their character, and of how well they have adapted and managed a difficult illness.

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