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Gulf War Syndrome or Gulf War Illness (GWI) has been used to describe a collection of chronic signs and symptoms reported by U.S., British, Canadian, Czech, Danish, Saudi, Egyptian, Australian and other Coalition Armed Forces that were deployed to Operation Desert Storm in 1991.
Over 100,000 American veterans of Desert Storm /Desert Shield (approximately 15% of deployed U.S. Armed Forces) returned from the Persian Gulf and slowly (over 6-24 months or more) and presented with a variety of complex signs and symptoms characterized by disabling fatigue, intermittent fevers, night sweats, arthralgia, myalgia, impairments in short-term memory, headaches, skin rashes, intermittent diarrhea, abdominal bloating, chronic bronchitis, photophobia, confusion, transient visual scotomata, irritability and depression and other signs and symptoms that until recently have defied appropriate diagnoses. These symptoms are not localized to any one organ, and the signs and symptoms and routine laboratory test results are not consistent with a single, specific disease.
Unfortunately, when a veteran has symptoms suggestive of GWI, the type of care they get may depend on the type of doctor they see. A 2001 study shows that mental healthcare workers are more likely to believe that GWI is caused by a physical factor such as a contagious or toxic agent, while general internal medicine doctors are more likely to believe the syndrome is caused by mental illness. "It's particularly frustrating for patients when they are bounced back and forth between clinicians and psychologists", says lead author Dr. Ralph D. Richardson, co-director of the Gulf War Clinic in Portland, Oregon. [Archives of Internal Medicine, May 28th, 2001;161: pp.1289-94]
Although there is not yet a case definition for Gulf War Illness, the chronic signs and symptoms loosely fit the clinical criteria for Chronic Fatigue Syndrome and/or Fibromyalgia Syndrome. Some patients also have what appears to be neurotoxicity and brainstem dysfunction that can result in autonomic, cranial and peripheral nerve demyelination, possibly due to complex chemical exposures. Often these patients have been diagnosed with Multiple Chemical Sensitivity Syndrome (MCS) or Organophosphate-Induced Delayed Neurotoxicity (OPIDN). Chemically-exposed patients can be treated by removal of offending chemicals from the patient's environment, depletion of chemicals from the patient's system and treatment of the neurotoxic signs and symptoms caused by chemical exposure(s).
Causes & Development
Some 40% of GWI patients have transmittible infections, including mycoplasmal and possibly other chronic bacterial infections, that have resulted in the appearance of GWI in immediate family members and civilians in the Gulf region. It is likely that veterans of the Gulf War who are ill with GWI owe their illnesses to a variety of exposures:- chemical mixtures, primarily organophosphates, antinerve agents and possibly nerve agents
- radiological sources, primarily depleted uranium and possibly fallout from destroyed nuclear reactors
- biological sources, primarily bacteria, viruses and toxins, before, during and after the conflict.
Such exposures can result in poorly-defined chronic illnesses, but these illnesses can be treated if appropriate diagnoses are forthcoming.
Signs & Symptoms
Symptoms include, but are not limited to, the following: Severe Headaches; Rashes; Joint Pain; Muscle Pain; Nerve/Neurological Damage; Kidney Damage; Lung Damage; Cardiovascular signs or symptoms; Thyroid Disease; Multiple Cancers; Auto-Immune Deficiencies; Unusual Fevers; Night Sweats; Fluid Buildup; Sleep Disturbances; Gastrointestinal signs or symptoms; Genetic Alterations; Abnormal Births; Birth Defects; Menstrual Problems; Reduced IQ; Confusion; Memory Loss; Blood In Stools and Urine; Fybromyligia; Epstein Barr Syndrome; Sinus Diseases; Micoplasma Fermentans; Incognitis Infections; Unusual Hair Loss; Loss Of Smell; Chemical Sensitivities; Asthma; Vision Problems.
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Risk factors for Gulf War Illness:
Gulf War Illness could instead be:
Recommendations and treatments for Gulf War Illness: | | | | | Drug |  Antibiotics | Scientists at The Institute for Molecular Medicine have found that slightly under one-half of the very sick Gulf War Illness patients in a pilot study with the signs and symptoms of Chronic Fatigue Syndrome or Fibromyalgia have chronic invasive infections involving certain uncommon mycoplasmas, such as Mycoplasma fermentans (incognitus strain). This has now been confirmed in a large Department of Defense - Department of Veterans' Affairs clinical trial.
Staff at The Institute for Molecular Medicine have recommended that these infections can be successfully treated with certain antibiotics, allowing the recovery of patients who have been long-term disabled. Similarly, in ongoing preliminary studies on Chronic Fatigue Syndrome and Fibomyalgia patients, we have found that a subset of patients have mycoplasmal infections that can be successfully treated with antibiotics, allowing patients to recover from their illnesses. |
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KEY | | Weak or unproven link |  | | Strong or generally accepted link | | | May do some good |
GLOSSARY
Abdomen (Abdominal)
That part of the body between the chest and the hips that contains the stomach, intestines, liver, bladder, pancreas and other organs.
Arthralgia
Severe throbbing or stabbing pain along a nerve in one or more joints.
Asthma (Asthmatic)
A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress. Extrinsic Asthma is triggered by pollen, chemicals or some other external agent; Intrinsic Asthma is triggered by boggy membranes, congested tissues, or other native causes… even adrenalin stress or exertion.
Bacteria (Bacterial, Bacterium)
Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Bronchitis
Inflammation of the mucous membrane of the bronchial tubes, frequently accompanied by cough, hypersecretion of mucus, and expectoration of sputum. Acute bronchitis is usually caused by an infectious agent and of short duration. Chronic bronchitis, generally the result of smoking, may also be known as Chronic Obstructive Pulmonary Disease (COPD) or Emphysema.
Cardiovascular
Pertaining to the heart and blood vessels.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Chronic Fatigue Syndrome (CFS, Chronic Fatigue)
A disorder of unknown cause that lasts for prolonged periods and causes extreme and debilitating exhaustion as well as a wide range of other symptoms such as fever, headache, muscle ache and joint pain, often resembling flu and other viral infections. Also known as Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS), Chronic Epstein-Barr Virus (CEBV), Myalgic Encephalomyelitis (ME), "Yuppy Flu" and other names, it is frequently misdiagnosed as hypochondria, psychosomatic illness, or depression, because routine medical tests do not detect any problems.
Diarrhea
Excessive discharge of contents of bowel.
Fibromyalgia (FMS)
Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.
Gastrointestinal (GI, GI Tract)
Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.
Kidneys (Kidney, Renal)
Bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage. The kidneys are sophisticated reprocessing machines, each day handling about 50 gallons of blood to sift out about half a gallon of waste products and extra water. The waste and extra water become urine, which flows to the bladder through tubes called ureters. The actual filtering occurs in tiny units inside the kidneys called nephrons. Every kidney has about a million nephrons. In a nephron, a glomerulus -- which is a tiny blood vessel, or capillary -- intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system. The kidneys recycle chemicals such as sodium, phosphorus, and potassium and thus regulate their levels. Renal: Pertaining to the kidneys.
Lung (Lungs, Pulmonary)
Organ of the body, located in the chest cavity which is designed to bring oxygen from the air into the blood stream, while also expelling carbon dioxide and other waste gases out of the body. Pulmonary: Related to the lungs.
Menstruation (Menses, Menstrual, Menstrual Cycle, Menstrual Cycles, Menstrual Flow, Menstrual Phase, Monthly Cycle)
The periodic discharge of blood, tissue fluid and mucus from the endometrium (lining of the uterus) that usually lasts from 3 - 5 days. It is caused by a sudden reduction in estrogens and progesterone.
Multiple Chemical Sensitivity (Chemical Hypersensitivity, Environmental Illness, MCS)
The diagnostic label of Multiple Chemical Sensitivity (MCS) is being applied increasingly, although definition of the phenomenon is elusive. MCS has become more widely known and increasingly controversial as more patients receive the label. Persons with the label of multiple chemical sensitivity are said to suffer multisystem illnesses as a result of contact with - or proximity to - a spectrum of substances, including airborne agents. These may include both recognized pollutants and other pollutants ordinarily considered harmless. Some doctors believe that MCS is a purely psychological issue. Others, however, counter that the disorder can cause the kinds of problems that keep those who are affected from leading a normal life.
Myalgia
Diffuse muscle pain.
Neurotoxic (Neurotoxin)
Poisonous to the nerves.
Short-Term Memory (Short Term Memory)
Also known as immediate memory or working memory, this is a phase of memory in which a limited amount of information may be held for several seconds to minutes. In general, up to 7 'chunks' of information are stored for about 20 seconds.
Sinuses (Sinus)
Four pairs of air pockets lined with membranes in the bones around the nose. The ethmoid sinuses are located on each side of the nose between the eyes; the maxillary sinuses are located in the cheek above the teeth and below the eyes; the sphenoid sinuses are located deeply behind the eyes; the frontal sinuses are located in the forehead.
Syndrome
A medical condition characterized by a collection of related symptoms (what the patient feels) and signs (what a doctor can observe or measure).
Thyroid (Thyroid Gland)
The thyroid gland is an organ with many veins, anchored around the front of the throat near the voice box. It is essential to normal body growth in infancy and childhood. It absorbs iodine from the diet and releases thyroid hormones - iodine-containing compounds that help govern the rate of the body's metabolism (its total life processes), affecting body temperature, and regulating protein, fat and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor. To a high degree, metabolism is regulated by the hormone thyroxine, which can be made by the thyroid if enough organic iodine is available. An enlarged thyroid gland that is not cancer is sometimes called goitre.
Virus (Viri, Viruses)
Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
Last updated: Oct 08, 2008
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