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To the Editor: In his book review of Whiplash and Other Useful Illnesses,¹ Dr Ehrlich² was dismissive of patients with such distressing disorders as fibromyalgia and chronic fatigue syndrome (CFS). Besides claiming that these conditions are "pseudoillnesses" and that their symptoms are "illogical complaints," Ehrlich finds "delightful" the book's offensive suggestion that what accounts for those "untenable diagnoses" is the "abundant compensation" paid for them.

Chronic fatigue syndrome shares many features with Addison disease and, thus, may have an endocrine component.^3-5

Riccardo Baschetti, MD
Fortaleza, Brazil

1. Malleson A. Whiplash and Other Useful Illnesses. Montreal, Quebec: McGill-Queen's University Press; 2002. 2. Ehrlich GE. Whiplash and other useful illnesses [book review]. JAMA. 2002;288:2617-2618. FREE FULL TEXT 3. Baschetti R. Chronic fatigue syndrome, decreased exercise capacity, and adrenal insufficiency. Arch Intern Med. 2001;161:1558-1559. FREE FULL TEXT 4. Kuratsune H, Yamaguti K, Sawada M, et al. Dehydroepiandrosterone sulfate deficiency in chronic fatigue syndrome. Int J Mol Med. 1998;1:143-146. ISI | PUBMED 5. Hunt PJ, Gurnell EM, Huppert FA, et al. Improvement in mood and fatigue after dehydroepiandrosterone replacement in Addison's disease in a randomized, double blind trial. J Clin Endocrinol Metab. 2000;85:4650-4656. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:1385.

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