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\fi-360\li4320 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698689\'01\u-3913 ?;}{\levelnumbers;}\f3\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 
\fi-360\li5040 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698691\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 
\fi-360\li5760 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698693\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 
\fi-360\li6480 }{\listname ;}\listid1603948661}{\list\listtemplateid97686092\listhybrid{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698689
\'01\u-3913 ?;}{\levelnumbers;}\f3\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li720 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698691
\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li1440 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698693
\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li2160 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698689
\'01\u-3913 ?;}{\levelnumbers;}\f3\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li2880 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698691
\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li3600 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698693
\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li4320 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698689
\'01\u-3913 ?;}{\levelnumbers;}\f3\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li5040 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698691
\'01o;}{\levelnumbers;}\f2\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li5760 }{\listlevel\levelnfc23\levelnfcn23\leveljc0\leveljcn0\levelfollow0\levelstartat1\levelspace0\levelindent0{\leveltext\leveltemplateid67698693
\'01\u-3929 ?;}{\levelnumbers;}\f14\chbrdr\brdrnone\brdrcf1 \chshdng0\chcfpat1\chcbpat1\fbias0 \fi-360\li6480 }{\listname ;}\listid2094618462}}{\*\listoverridetable{\listoverride\listid1389259017\listoverridecount0\ls1}{\listoverride\listid1603948661
\listoverridecount0\ls2}{\listoverride\listid338848276\listoverridecount0\ls3}{\listoverride\listid62879455\listoverridecount0\ls4}{\listoverride\listid1335954042\listoverridecount0\ls5}{\listoverride\listid1523278951\listoverridecount0\ls6}
{\listoverride\listid890001967\listoverridecount0\ls7}{\listoverride\listid2094618462\listoverridecount0\ls8}}{\info{\title Chronic Fatigue Syndrome}{\author Valued Acer Customer}{\operator Chris}{\creatim\yr2010\mo7\dy9\hr20\min17}
{\revtim\yr2010\mo7\dy9\hr20\min17}{\version2}{\edmins1}{\nofpages2}{\nofwords247}{\nofchars1412}{\nofcharsws1734}{\vern8283}}\margl1440\margr1440 
\widowctrl\ftnbj\aenddoc\noxlattoyen\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\hyphcaps0\formshade\horzdoc\dgmargin\dghspace180\dgvspace180\dghorigin1440\dgvorigin1440\dghshow1\dgvshow1
\jexpand\viewkind1\viewscale100\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule \fet0{\*\ftnsep \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0 \chftnsep 
\par }}{\*\ftnsepc \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0 \chftnsepc 
\par }}{\*\aftnsep \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0 \chftnsep 
\par }}{\*\aftnsepc \pard\plain \ql \li0\ri0\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0 \chftnsepc 
\par }}\sectd \linex0\headery708\footery708\colsx708\endnhere\sectlinegrid360\sectdefaultcl {\header \pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Ref NICE quick reference guideline No 53
\par }\pard\plain \s16\ql \li0\ri0\widctlpar\tqc\tx4680\tqr\tx9360\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0 
\par 
\par }}{\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang{\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang{\pntxta )}}
{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl8
\pnlcltr\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang{\pntxtb (}{\pntxta )}}\pard\plain \qc \li0\ri0\sa200\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs36\lang2057\langfe1033\langnp2057 Chronic Fatigue Syndrome}{\f0\fs36\lang2057\langfe1033\langnp2057 
\par }\pard \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\fs24\lang2057\langfe1033\langnp2057 Epidemiology: GP practice with 10 000 patients will have 40 cases. 
\par Note: The underlying disease process is unknown.
\par }{\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Main Symptoms
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls1\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Fatigue}{\f0\fs24\lang2057\langfe1033\langnp2057 
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}{\fs24\lang2057\langfe1033\langnp2057 Malaise
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Headaches
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Sleep disturbance
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Concentration difficulties
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Muscle pain
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 The pattern and intensity of symptoms are very variable.

\par }{\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Key elements of care
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls2\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Involve the person with CFS in decisions
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Identify and manage symptoms early
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Make accurate diagnosis after considering alternative diagnosis
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Diagnosis after alternatives excluded:
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls3\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 At 4 months in adults
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}3 months in children (by paediatrician)
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Consider the diagnosis if }{\b\fs24\lang2057\langfe1033\langnp2057 fatigue}{\fs24\lang2057\langfe1033\langnp2057  is present with }{\b\fs24\lang2057\langfe1033\langnp2057 all}{\fs24\lang2057\langfe1033\langnp2057 
 of:}{\f0\fs24\lang2057\langfe1033\langnp2057 
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls4\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 New onset
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Persistent or recurrent
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Unexplained
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Substantial reduction in mental or physical activity
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 And one or more of the following are present
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls5\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Sleep disturbance
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Muscle or joint pains
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Headaches
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Painful lymph nodes or sore throat
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Cognitive dysfunction
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Worse after physical or mental exertion
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Dizziness or nausea
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Palpitations without cardiac cause
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Red flags to investigate
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls6\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Neurological signs
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Signs, symptoms of inflammatory arthritis of connective tissue disease
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Signs symptoms cardio-respiratory disease}{\f0\fs24\lang2057\langfe1033\langnp2057 
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}{\fs24\lang2057\langfe1033\langnp2057 Significant weight loss
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Sleep apnoea
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Enlarged lymph nodes
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Routine investigations
\par }\trowd \trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24\lang2057\langfe1033\langnp2057 Urinalysis\cell Random glucose\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24\lang2057\langfe1033\langnp2057 FBC\cell Gluten sensitivity test\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24\lang2057\langfe1033\langnp2057 UsEs & LFTs\cell Serum calcium\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24\lang2057\langfe1033\langnp2057 TFTs\cell Creatinine kinase\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24\lang2057\langfe1033\langnp2057 ESR/PV\cell Ferritin (children only)\cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\pard 
\ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\fs24\lang2057\langfe1033\langnp2057 CRP\cell \cell }\pard \ql \li0\ri0\widctlpar\intbl\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\trowd 
\trgaph108\trleft-108\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3 \clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx4680\clvertalt\cltxlrtb\clftsWidth3\clwWidth4788 \cellx9468\row }\pard 
\ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 {\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Diagnosis unlikely if none of the following are present:}{\f0\fs24\lang2057\langfe1033\langnp2057 
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls7\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Post exertion fatigue
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Sleep disturbance
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Cognitive difficulty
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Chronic pain
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0\fs24\lang2057\langfe1033\langnp2057 
\par }{\fs24\lang2057\langfe1033\langnp2057 Information about CFS
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}}\pard\plain \s15\ql \fi-360\li720\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\ls8\adjustright\rin0\lin720\itap0 
\f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\fs24\lang2057\langfe1033\langnp2057 Give honest and realistic information, encourage cautious optimism
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Most people over time return to work and normal activity
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Others relapse or remain house bound
\par {\listtext\pard\plain\s15 \f3\lang2057\langfe1033\langnp2057 \loch\af3\dbch\af0\hich\f3 \'b7\tab}Prognosis best in children or young adults
\par }\pard\plain \ql \li0\ri0\sl276\slmult1\widctlpar\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \f43\fs22\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\f0\fs24\lang2057\langfe1033\langnp2057 
\par 
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\par }}