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ORIGINAL RESEARCH ARTICLE

Hematologic and Urinary Excretion Anomalies in Patients with Chronic Fatigue Syndrome

Suzanne H. Niblett^*, Katrina E. King^*, R. Hugh Dunstan^*,1, Phillip Clifton-Bligh, Leigh A. Hoskin, Timothy K. Roberts^*, Greg R. Fulcher, Neil R. McGregor, Julie C. Dunsmore, Henry L. Butt, Iven Klineberg^|| and T. B. Rothkirch^*

^* Environmental and Pathogenic Microbiology Laboratory, Discipline of Biological Sciences, University of Newcastle, Callaghan 2308, Australia; Department of Endocrinology, Royal North Shore Hospital, University of Sydney, St. Leonards 2065, Australia; Service Improvement Unit, Westmead Childrens’ Hospital, Westmead 2145, Australia; Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville 3012, Australia; and ^|| Neurobiology Research Unit, Centre for Oral Health Research, University of Sydney, Westmead Hospital, Westmead 2084, Australia

To whom requests for reprints should be addressed at ¹ Environmental and Pathogenic Microbiology Laboratory, School of Environmental and Life Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia. E-mail: hugh.dunstan{at}newcastle.edu.au

Patients with chronic fatigue syndrome (CFS) have a broad and variable spectrum of signs and symptoms with variable onsets. This report outlines the results of a single-blind, cross-sectional research project that extensively investigated a large cohort of 100 CFS patients and 82 nonfatigued control subjects with the aim of performing a case-control evaluation of alterations in standard blood parameters and urinary amino and organic acid excretion profiles. Blood biochemistry and full blood counts were unremarkable and fell within normal laboratory ranges. However, the case-control comparison of the blood cell data revealed that CFS patients had a significant decrease in red cell distribution width and increases in mean platelet volume, neutrophil counts, and the neutrophil-lymphocyte ratio. Evaluation of the urine excretion parameters also revealed a number of anomalies. The overnight urine output and rate of amino acid excretion were both reduced in the CFS group (P < 0.01). Significant decreases in the urinary excretion of asparagine (P < 0.0001), phenylalanine (P < 0.003), the branch chain amino acids (P < 0.005), and succinic acid (P < 0.0001), as well as increases in 3-methylhistidine (P < 0.05) and tyrosine (P < 0.05) were observed. It was concluded that the urinary excretion and blood parameters data supported the hypothesis that alterations in physiologic homeostasis exist in CFS patients.

Key Words: chronic fatigue syndrome • CFS • CFIDS • myalgic encephalomyelitis • ME • urine analyses • hematology • homeostasis