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Autopsy in Myalgic Encephalomyelitis
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== Other post-mortem findings == The results of the autopsies of four ME/CFS patients were presented at the International Science Symposium on ME/CFS, 2010, Bond University, Australia.<ref>{{Cite web | url = http://www.meassociation.org.uk/wp-content/uploads/2011/01/Ros-Vallings-report.doc | title = Pathology of Chronic Fatigue Syndrome: Pilot Study of Four Autopsy Cases. DG O’Donovan, T Harrower, S Cader, LJ Findley, C Shepherd, A Chaudhuri. Presented at the International Science Symposium on ME/CFS, 2010, Bond University, Australia. | date = |access-date= | website = | last = | first = |archive-url=|archive-date=|url-status=}}</ref> These autospy studies were not looking for enterovirus, but examined the general features of the brain and nervous system. * A 32 year old male had ME/CFS for 20 years and died of suicide by medication overdose. The autopsy showed excess corpora amylacea in the [[spinal cord]] and [[brain]]. There were intermediate filaments closely related to glial cells, and maybe within the glia rather than the axons. No evidence of ganglionitis. (EBV negative). * A 32 year old female had ME/CFS for 5 years. She refused medical help, was bedridden and refused food and water. She finally died of renal failure. The autopsy showed a focal chronic inflammatory infiltrate (T8 lymphocyes) in the [[dorsal root ganglia]]. ([[Epstein-Barr virus|EBV]] negative). * A 43 year old female arranged for assisted suicide in Switzerland by barbiturate overdose. The brain showed global ischemia, but this was likely due to the drugs used. Dorsal root ganglia showed mild excess of lymphocytic nodules of nageotte but with no obvious inflammation, but this could represent a subtle chronic inflammatory state. * A 31 year old female with ME/CFS may have died from opiate ingestion. She had toxic demyelination with spinal subarachnoid hemorrhage, but she was on warfarin. There was some mild possible chronic ganglionitis. Autopsies of two patients who died from other causes several months after contracting ME/CFS in the 1955 [[1955 Royal Free Hospital outbreak|Royal Free hospital outbreak]] revealed distinct brain abnormalities in one case, but not in the other:<ref>{{Cite journal | last = Crowley | first = Nuala | last2 = Nelson | first2 = Merran | last3 = Stovin | first3 = Sybille | date = Mar 1957 | title = Epidemiological aspects of an outbreak of encephalomyelitis at the Royal Free Hospital, London, in the summer of 1955 | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2217874/ | journal = The Journal of Hygiene | volume = 55 | issue = 1 | pages = 102–122|issn=0022-1724|pmc=2217874|pmid=13416578}}</ref> * A 32 year old female had had ME/CFS for 7 months at the time of death (due to barbiturate poisoning). A brain post-mortem showed small grey or yellowish plaques in the white matter of the cerebral hemispheres (mainly paraventricular in distribution), in the brain stem, and in the spinal cord (particularly in the cervical segment). Microscopic brain tissue examination showed multiple areas of demyelination with associated microglia and astrocyte proliferation and gliosis. One section from the hypothalamus showed intense perivascular cuffing (accumulation of lymphocytes or plasma cells), which it was concluded could be due to viral encephalitis, or due an unusual reaction associated with the white matter sclerosis . * The other Royal Free epidemic ME/CFS patient autopsied was found to have septicemia, clostridial peritonitis and ovarian carcinoma with multiple metastases. Microscopic examination of the brain, spinal cord and peripheral nerves showed no abnormalities except for those attributable to the septicemia or the disseminated carcinoma.
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