I must admit, I had to look this one up in the Merck Manual. It is relatively rare in the US and is more common along the Mediterranean silk route and in Japan. It has no specific symptoms but is a clinical diagnosis that takes months to confirm. The cause is unknown, but it seems to involve inflammatory processes and possibly a chronic viral process. While symptoms may improve on their own, it might be very helpful to talk to your local licensed ND, available at www.naturopathic.org, to see if your brother is interested in doing any of the diet or lifestyle changes known to help with inflammation.

Best of luck, Chris Maloney, Naturopathic Doctor Portland Maine www.maloneymedical.com