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"How rare is `Walter Payton's disease' and would a new liver have saved his life?"

`WALTER PAYTON'S DISEASE'

Q With the recent death of football great Walter Payton, I heard for the first time about the rare disease that took his life. I can't pronounce it and simply call it "Walter Payton's disease." How rare is it, and would a new liver have been enough to save his life? T.R., Kansas City, Mo.

A Because it is a mouthful to say, primary sclerosing cholangitis might very well become commonly known as "Walter Payton's disease," the same way that amyotrophic lateral sclerosis (ALS) is primarily referred to as "Lou Gehrig's disease."

Doctors say primary sclerosing cholangitis is a rare liver disease that causes a narrowing of the bile ducts inside and outside the liver. Its cause is unknown, and when the inflammation spreads, the bile ducts are destroyed and scar tissue is created. In some cases, the tissue can become cancerous. Doctors say that's what happened in Payton's case, and he died as a result of bile-duct cancer.

Once the cancer was discovered, Payton was no longer considered a transplant candidate. At that stage, a new liver would not have saved his life, doctors say, because the cancer probably had spread beyond the liver or because the cancer likely would have recurred in a transplanted liver.

Primary sclerosing cholangitis, a disease that strikes only about three people out of every 100,000, usually affects males between the ages of 40 and 50, doctors say. The disease can go unnoticed for years because it causes vague symptoms that include fatigue and itching, and is not necessarily associated with a history of liver disease.

IDENTIFYING CHRONIC FATIGUE SYNDROME

Q I am a 33-year-old, single female who works a 40-hour week but have few outside activities. My problem is that I am tired all the time, no matter how much sleep I get. When I wake up in the morning, I'm tired. When I go to work, I'm tired. When I go to bed at night, I'm tired. Could I be a victim of what they call chronic fatigue syndrome? L.W., Baltimore

Since fatigue is a symptom of a variety of medical conditions (such as liver, thyroid or kidney problems), you should contact your physician as soon as possible to schedule a thorough physical examination, which can lead to the identification of the cause of your constant exhaustion.

A It's possible that you are a victim of chronic fatigue syndrome (sometimes called "yuppie flu"), a condition that can strike anyone at any age, doctors say, but it's three times more common in women for reasons that are unknown. In addition to feelings of being constantly worn out, many victims complain of flu-like symptoms and often have low blood pressure, difficulty with concentration, poor short-term memory, irritability, a recurring sore throat, a low-grade fever and swollen lymph nodes.

The exact cause of chronic fatigue syndrome is unknown, but some researchers suspect it may be caused by a virus, however, no distinct viral cause has been identified. Doctors say there is currently no treatment that has been proven to be effective in curing the illness, instead the symptoms are treated. In addition to some medication, patients with chronic fatigue syndrome are encouraged to maintain active social lives, and mild physical exercise may also be helpful.

BACTERIAL VAGINOSIS

Q My girlfriend, who has frequent yeast infections, went to her doctor to be treated for what she thought was a yeast infection. However, she was told that she had a condition called bacterial vaginosis. What is it? How common is it? And how serious is it? K.G., Denver

A Bacterial vaginosis is the most common kind of vaginal infection, physicians say, and most women will get it at some point in their childbearing years. It is caused by the rapid growth of certain types of bacteria that upset the balance of "good" and "bad" types of bacteria in the vagina. In most cases, it's not dangerous but could cause problems for women who are pregnant or those having gynecological surgery. Symptoms include a strong fishy smell, a white or gray discharge, or a watery or foamy discharge.

# posted by Medical Information : 4:36 AM