March 14, 2014

IOM unable to define 'Gulf War' illness

IOM unable to define 'Gulf War' illness

HealthDay News -- Two definitions for chronic multisymptom illness should be used to identify cases of Gulf War illness among Gulf War veterans, according to a report from the Institute of Medicine.

Kenneth Shine, MD, from the University of Texas in Austin, and colleagues reviewed more than 700 studies to develop a case definition for chronic multisymptom illness in relation to 1990 to 1991 Gulf War veterans. As many as 250,000 veterans experience symptoms including fatigue, joint and muscle pain, respiratory problems and gastrointestinal distress.

Recognizing the difficulty of establishing a case definition given the lack of uniform symptoms, the variety of symptoms, and the long onset and duration, the researchers note that the absence of an agreed upon definition may limit the ability to select and administer treatments.

"[T]he committee has concluded that the available evidence is insufficient to develop a new case definition of [Gulf War Illness],” the researchers wrote.

Although the committee could not recommend one specific case definition, it did recommend consideration of two case definitions on the basis of their concordance with the evidence.

The CDC and the Kansas definitions seem to describe the array of symptoms most frequently reported by veterans. To capture the population of interest and symptoms, the researchers recommended use of the term "Gulf War illness" rather than chronic multisymptom illness.

"The diversity and intensity of exposures and experiences, as well as the breadth and extent of symptoms, warrant workable definitions of the illness and nomenclature so the U.S. Department of Veterans Affairs can advance research and administer effective treatments," Shine said in a statement.