Clinical Laboratory Test Findings in Patients With Chronic Fatigue Syndrome

David W. Bates, Dedra Buchwald, Joshua Lee, Phalla Kith, Teresa Doolittle, Cynthia Rutherford, W. Hallowell Churchill, Peter H. Schur, Mark Wener, Donald Wybenga, James Winkelman, Anthony L. Komaroff

Research output: Contribution to journalArticle

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Abstract

Background: Results of readily available clinical laboratory tests in patients with chronic fatigue syndrome were compared with results in healthy control subjects. Methods: Cases consisted of all 579 patients who met either the Centers for Disease Control and Prevention, Atlanta, Ga, British, or Australian case definition for chronic fatigue syndrome. They were from chronic fatigue clinics in Boston, Mass, and Seattle, Wash. Control subjects consisted of 147 blood donors who denied chronic fatigue. Outcome measures were the results of 18 clinical laboratory tests. Results: Age- and sex-adjusted odds ratios of abnormal results, comparing cases with control subjects, were as follows: circulating immune complexes, 26.5 (95% confidence interval [CI], 3.4-206); atypical lymphocytosis, 11.4 (95% CI, 1.4-94); elevated immunoglobulin G, 8.5 (95% CI, 2.0-37); elevated alkaline phosphatase, 4.2 (95% CI, 1.6-11); elevated total cholesterol, 2.1 (95% CI, 1.2-3.4); and elevated lactic dehydrogenase, 0.30 (95% CI, 0.16-0.56). Also, antinuclear antibodies were detected in 15% of cases vs 0% in the control subjects. The results of these tests were generally comparable for the cases from Seattle and Boston. Although these tests served to discriminate the population of patients from healthy control subjects, at the individual level they were not as useful. Conclusions: Patients with chronic fatigue syndrome who were located in two geographically distant areas had abnormalities in the results of several readily available clinical laboratory tests compared with healthy control subjects. The immunologic abnormalities are in accord with a growing body of evidence suggesting chronic, low-level activation of the immune system in chronic fatigue syndrome. While each of these laboratory findings supports the diagnosis of chronic fatigue syndrome, each lacks sufficient sensitivity to be a diagnostic test. Furthermore, the specificity of these findings relative to other organic and psychiatric conditions that can produce fatigue remains to be established.

Original languageEnglish (US)
Pages (from-to)97-103
Number of pages7
JournalArchives of Internal Medicine
Volume155
Issue number1
DOIs
StatePublished - Jan 9 1995

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Chronic Fatigue Syndrome
Confidence Intervals
Fatigue
Healthy Volunteers
Lymphocytosis
Antinuclear Antibodies
Centers for Disease Control and Prevention (U.S.)
Hypercholesterolemia
Antigen-Antibody Complex
Blood Donors
Routine Diagnostic Tests
Alkaline Phosphatase
Psychiatry
Immune System
Oxidoreductases
Milk
Immunoglobulin G
Odds Ratio
Outcome Assessment (Health Care)
Population

ASJC Scopus subject areas

  • Internal Medicine

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Clinical Laboratory Test Findings in Patients With Chronic Fatigue Syndrome. / Bates, David W.; Buchwald, Dedra; Lee, Joshua; Kith, Phalla; Doolittle, Teresa; Rutherford, Cynthia; Churchill, W. Hallowell; Schur, Peter H.; Wener, Mark; Wybenga, Donald; Winkelman, James; Komaroff, Anthony L.

In: Archives of Internal Medicine, Vol. 155, No. 1, 09.01.1995, p. 97-103.

Research output: Contribution to journalArticle

Bates, DW, Buchwald, D, Lee, J, Kith, P, Doolittle, T, Rutherford, C, Churchill, WH, Schur, PH, Wener, M, Wybenga, D, Winkelman, J & Komaroff, AL 1995, 'Clinical Laboratory Test Findings in Patients With Chronic Fatigue Syndrome', Archives of Internal Medicine, vol. 155, no. 1, pp. 97-103. https://doi.org/10.1001/archinte.1995.00430010105014
Bates, David W. ; Buchwald, Dedra ; Lee, Joshua ; Kith, Phalla ; Doolittle, Teresa ; Rutherford, Cynthia ; Churchill, W. Hallowell ; Schur, Peter H. ; Wener, Mark ; Wybenga, Donald ; Winkelman, James ; Komaroff, Anthony L. / Clinical Laboratory Test Findings in Patients With Chronic Fatigue Syndrome. In: Archives of Internal Medicine. 1995 ; Vol. 155, No. 1. pp. 97-103.
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abstract = "Background: Results of readily available clinical laboratory tests in patients with chronic fatigue syndrome were compared with results in healthy control subjects. Methods: Cases consisted of all 579 patients who met either the Centers for Disease Control and Prevention, Atlanta, Ga, British, or Australian case definition for chronic fatigue syndrome. They were from chronic fatigue clinics in Boston, Mass, and Seattle, Wash. Control subjects consisted of 147 blood donors who denied chronic fatigue. Outcome measures were the results of 18 clinical laboratory tests. Results: Age- and sex-adjusted odds ratios of abnormal results, comparing cases with control subjects, were as follows: circulating immune complexes, 26.5 (95{\%} confidence interval [CI], 3.4-206); atypical lymphocytosis, 11.4 (95{\%} CI, 1.4-94); elevated immunoglobulin G, 8.5 (95{\%} CI, 2.0-37); elevated alkaline phosphatase, 4.2 (95{\%} CI, 1.6-11); elevated total cholesterol, 2.1 (95{\%} CI, 1.2-3.4); and elevated lactic dehydrogenase, 0.30 (95{\%} CI, 0.16-0.56). Also, antinuclear antibodies were detected in 15{\%} of cases vs 0{\%} in the control subjects. The results of these tests were generally comparable for the cases from Seattle and Boston. Although these tests served to discriminate the population of patients from healthy control subjects, at the individual level they were not as useful. Conclusions: Patients with chronic fatigue syndrome who were located in two geographically distant areas had abnormalities in the results of several readily available clinical laboratory tests compared with healthy control subjects. The immunologic abnormalities are in accord with a growing body of evidence suggesting chronic, low-level activation of the immune system in chronic fatigue syndrome. While each of these laboratory findings supports the diagnosis of chronic fatigue syndrome, each lacks sufficient sensitivity to be a diagnostic test. Furthermore, the specificity of these findings relative to other organic and psychiatric conditions that can produce fatigue remains to be established.",
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AU - Churchill, W. Hallowell

AU - Schur, Peter H.

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N2 - Background: Results of readily available clinical laboratory tests in patients with chronic fatigue syndrome were compared with results in healthy control subjects. Methods: Cases consisted of all 579 patients who met either the Centers for Disease Control and Prevention, Atlanta, Ga, British, or Australian case definition for chronic fatigue syndrome. They were from chronic fatigue clinics in Boston, Mass, and Seattle, Wash. Control subjects consisted of 147 blood donors who denied chronic fatigue. Outcome measures were the results of 18 clinical laboratory tests. Results: Age- and sex-adjusted odds ratios of abnormal results, comparing cases with control subjects, were as follows: circulating immune complexes, 26.5 (95% confidence interval [CI], 3.4-206); atypical lymphocytosis, 11.4 (95% CI, 1.4-94); elevated immunoglobulin G, 8.5 (95% CI, 2.0-37); elevated alkaline phosphatase, 4.2 (95% CI, 1.6-11); elevated total cholesterol, 2.1 (95% CI, 1.2-3.4); and elevated lactic dehydrogenase, 0.30 (95% CI, 0.16-0.56). Also, antinuclear antibodies were detected in 15% of cases vs 0% in the control subjects. The results of these tests were generally comparable for the cases from Seattle and Boston. Although these tests served to discriminate the population of patients from healthy control subjects, at the individual level they were not as useful. Conclusions: Patients with chronic fatigue syndrome who were located in two geographically distant areas had abnormalities in the results of several readily available clinical laboratory tests compared with healthy control subjects. The immunologic abnormalities are in accord with a growing body of evidence suggesting chronic, low-level activation of the immune system in chronic fatigue syndrome. While each of these laboratory findings supports the diagnosis of chronic fatigue syndrome, each lacks sufficient sensitivity to be a diagnostic test. Furthermore, the specificity of these findings relative to other organic and psychiatric conditions that can produce fatigue remains to be established.

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