Tracking post-infectious fatigue in clinic using routine Lab tests

BMC Pediatrics

Research Article

Ben Z. Katz¹  Maurice R. G. O’Gorman²  Zachary M. Barnes³  Jeanna M. Harvey³  Gordon Broderick⁴  Mary Ann Fletcher⁵  Nancy G. Klimas⁵  Suzanne D. Vernon⁶  Alanna Bowie⁷  Renee Taylor⁸ 

[1] Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA;Children’s Hospital Los Angeles, Los Angeles, CA, USA;Department of Medicine, University of Miami, Miami, FL, USA;Department of Medicine, University of Miami, Miami, FL, USA;Institute for Neuro Immune Medicine, Nova Southeastern University, University Park Plaza, 3440 South University, 33328, Fort Lauderdale, FL, USA;University of Alberta, Edmonton, AB, Canada;Institute for Neuro Immune Medicine, Nova Southeastern University, University Park Plaza, 3440 South University, 33328, Fort Lauderdale, FL, USA;Solve ME/CFS Initiative, Charlotte, NC, USA;University of Alberta, Edmonton, AB, Canada;University of Illinois at Chicago, Chicago, IL, USA;

关键词: Blood glucose;    ACTH;    Estradiol;    Neutrophil count;    Free thyroxin;    Salivary cortisol;    Classification models;    Infectious mononucleosis;    EBV;    Chronic fatigue;   

DOI  :  10.1186/s12887-016-0596-8

 received in 2014-09-03, accepted in 2016-04-21,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundWhile 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.MethodsRoutine 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.ResultsLower 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.ConclusionsPreliminary 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.

【 授权许可】

CC BY   
© Harvey et al. 2016