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Chronic Fatigue Syndrome: A Working Case Definition
- GARY P. HOLMES, M.D.;
- JONATHAN E. KAPLAN, M.D.;
- NELSON M. GANTZ, M.D.;
- ANTHONY L. KOMAROFF, M.D.;
- LAWRENCE B. SCHONBERGER, M.D.;
- STEPHEN E. STRAUS, M.D.;
- JAMES F. JONES, M.D.;
- RICHARD E. DUBOIS, M.D.;
- CHARLOTTE CUNNINGHAM-RUNDLES, M.D.;
- SAVITA PAHWA, M.D.;
- GIOVANNA TOSATO, M.D.;
- LEONARD S. ZEGANS, M.D.;
- DAVID T. PURTILO, M.D.;
- NATHANIEL BROWN, M.D.;
- ROBERT T. SCHOOLEY, M.D.; and
- IRENA BRUS, M.D.
- Atlanta, Georgia; Worcester and Boston, Massachusetts; Bethesda, Maryland; Denver, Colorado; New York and Manhasset, New York; San Francisco, California; and Omaha, Nebraska
Abstract
The chronic Epstein-Barr virus syndrome is a poorly defined symptom complex characterized primarily by chronic or recurrent debilitating fatigue and various combinations of other symptoms, including sore throat, lymph node pain and tenderness, headache, myalgia, and arthralgias. Although the syndrome has received recent attention, and has been diagnosed in many patients, the chronic Epstein-Barr virus syndrome has not been defined consistently. Despite the name of the syndrome, both the diagnostic value of Epstein-Barr virus serologic tests and the proposed causal relationship between Epstein-Barr virus infection and patients who have been diagnosed with the chronic Epstein-Barr virus syndrome remain doubtful. We propose a new name for the chronic Epstein-Barr virus syndrome—the chronic fatigue syndrome—that more accurately describes this symptom complex as a syndrome of unknown cause characterized primarily by chronic fatigue. We also present a working definition for the chronic fatigue syndrome designed to improve the comparability and reproducibility of clinical research and epidemiologic studies, and to provide a rational basis for evaluating patients who have chronic fatigue of undetermined cause.
- axilla
- chronic disease
- depression
- Epstein-Barr virus
- fatigue
- fever
- lymph nodes
- memory disorders
- neck
- pharyngitis
- chronic Epstein-Barr virus syndrome
- chronic fatigue syndrome
- sore throat
- axilla
- chronic disease
- depression
- Epstein-Barr virus
- fatigue
- fever
- lymph nodes
- memory disorders
- neck
- pharyngitis
- chronic Epstein-Barr virus syndrome
- chronic fatigue syndrome
- sore throat
Article and Author Information
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▸From the Division of Viral Diseases, Centers for Disease Control, Atlanta, Georgia; Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Laboratory of Clinical Investigation, National Institutes of Health, Bethesda, Maryland; Department of Pediatrics, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado; Atlanta Medical Associates, Atlanta, Georgia; Department of Medicine, Mount Sinai Medical Center, New York, New York; Department of Pediatrics, North Shore University Hospital, Manhasset, New York; Division of Biochemistry and Biophysics, Food and Drug Administration, Bethesda, Maryland; Department of Psychiatry, University of San Francisco School of Medicine, San Francisco, California; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; and Department of Medicine, Beth Israel Medical Center, New York, New York.
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▸Requests for reprints should be addressed to Gary P. Holmes, M.D.; Division of Viral Diseases, Center for Infectious Diseases, Centers for Disease Control; Atlanta, GA 30333.
