In recent years there has been an upsurge of reports that the chronic illness characterized by extreme fatigue, known for many years as "neurasthenia," is associated with a recent viral infection. Coxsackie B viruses, EBV, CMV, HHV-6, and HTLV are among the many viruses to have been isolated from such patients, but no cause-effect relationship has been established. Immunologic abnormalities have also been recorded, such as mild IgA deficiencies and elevated levels of circulating immune complexes. A significant proportion of patients have histories of depression or susceptibility to mental illness prior to the development of "chronic fatigue syndrome." Some virologists and clinicians are skeptical about the existence of this disease as an entity. The present consensus is that infection with, or immunologic disorders due to, any of a variety of different viruses may contribute to at least some of these cases.
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