Tracking post-infectious fatigue in clinic using routine Lab tests

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Tracking post-infectious fatigue in clinic using routine Lab tests


RESEARCH ARTICLE

OPEN ACCESS
Tracking post-infectious fatigue in clinic using routine Lab tests
  • Jeanna M. Harvey,
  • Gordon BroderickEmail author,
  • Alanna Bowie,
  • Zachary M. Barnes,
  • Ben Z. Katz,
  • Maurice R. G. O’Gorman,
  • Suzanne D. Vernon,
  • Mary Ann Fletcher,
  • Nancy G. Klimas and
  • Renee Taylor
BMC PediatricsBMC series – open, inclusive and trusted201616:54
DOI: 10.1186/s12887-016-0596-8
© Harvey et al. 2016
Received: 3 September 2014
Accepted: 21 April 2016
Published: 26 April 2016
Open Peer Review reports
Abstract

Background


While biomarkers for chronic fatigue syndrome (CFS) are beginning to emerge they typically require a highly specialized clinical laboratory. We hypothesized that subsets of commonly measured laboratory markers used in combination could support the diagnosis of post-infectious CFS (PI-CFS) in adolescents following infectious mononucleosis (IM) and help determine who might develop persistence of symptoms.
Methods

Routine clinical laboratory markers were collected prospectively in 301 mono-spot positive adolescents, 4 % of whom developed CFS (n = 13). At 6, 12, and 24 months post-diagnosis with IM, 59 standard tests were performed including metabolic profiling, liver enzyme panel, hormone profiles, complete blood count (CBC), differential white blood count (WBC), salivary cortisol, and urinalysis. Classification models separating PI-CFS from controls were constructed at each time point using stepwise subset selection.
Results

Lower ACTH levels at 6 months post-IM diagnosis were highly predictive of CFS (AUC p = 0.02). ACTH levels in CFS overlapped with healthy controls at 12 months, but again showed a trend towards a deficiency at 24 months. Conversely, estradiol levels depart significantly from normal at 12 months only to recover at 24 months (AUC p = 0.02). Finally, relative neutrophil count showed a significant departure from normal at 24 months in CFS (AUC p = 0.01). Expression of these markers evolved differently over time between groups.
Conclusions

Preliminary results suggest that serial assessment of stress and sex hormones as well as the relative proportion of innate immune cells measured using standard clinical laboratory tests may support the diagnosis of PI-CFS in adolescents with IM.


http://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-016-0596-8
 

Seanko

Well-Known Member
A paper by Nancy Klimas & Suzanne Vernonon paediatric ME/CFS on the development of the illness after mono/glandular fever.

Interesting, especially after the furore over Nigel Speight & Esther Crawley on the UK.

Passed on details to somebody trying to drum up interest in paediatric ME/CFS here in Britain...
 

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