This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Dedra Buchwald, MD; John L. Sullivan, MD; Anthony L. Komaroff, MD

JAMA. 1987;257(17):2303-2307.

Abstract
Twenty-one percent of 500 unselected patients, aged 17 to 50 years, seeking primary care for any reason were found to be suffering from a chronic fatigue syndrome consistent with "chronic active Epstein-Barr virus (EBV) infection." They had been experiencing "severe" fatigue, usually cyclic, for a median of 16 months (range, six to 458 months), associated with sore throat, myalgias, or headaches; 45% of the patients were periodically bedridden; and 25% to 73% reported recurrent cervical adenopathy, paresthesias, arthralgias, and difficulty in concentrating or sleeping. The patients had no recognized chronic "physical" illness and were not receiving psychiatric care. While antibody titers to several EBV-specific antigens were higher in patients than in age- and sex-matched control subjects, the differences generally were not statistically significant. A chronic fatigue syndrome consistent with the chronic active EBV infection syndrome was prevalent in our primary care practice. However, our data offer no evidence that EBV is causally related to the syndrome. Indeed, we feel that among unselected patients seen in a general medical practice currently available EBV serologic test results must be interpreted with great caution.

(JAMA 1987;257:2303-2307)

Author Affiliations
From the Division of General Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (Drs Buchwald and Komaroff); and the Department of Pediatrics, Molecular Genetics, and Microbiology, University of Massachusetts, Worcester (Dr Sullivan).

Footnotes
Reprint requests to Division of General Medicine and Primary Care, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Komaroff).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Positive and Negative Psychological States and Economic Status as Mediators of the Relationship of Education to Fatigue Among Older Adults
Murrell et al.
Research on Aging 2004;26:673-700.
ABSTRACT  

Educational Attainment, Positive Psychological Mediators, and Resources for Health and Vitality in Older Adults
Murrell et al.
J Aging Health 2003;15:591-615.
ABSTRACT  

Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care
SKAPINAKIS et al.
Br. J. Psychiatry 2003;182:205-209.
ABSTRACT | FULL TEXT  

A Twin Study of Chronic Fatigue
Buchwald et al.
Psychosom. Med. 2001;63:936-943.
ABSTRACT | FULL TEXT  

Outcome of 48 Pediatric Patients With Chronic Fatigue: A Clinical Experience
Feder et al.
Arch Fam Med 1994;3:1049-1055.
ABSTRACT  

Prevalence of Fatigue and Chronic Fatigue Syndrome in a Primary Care Practice
Bates et al.
Arch Intern Med 1993;153:2759-2765.
ABSTRACT  

Information Processing Efficiency in Chronic Fatigue Syndrome and Multiple Sclerosis
DeLuca et al.
Arch Neurol 1993;50:301-304.
ABSTRACT  

A Chronic Illness Characterized by Fatigue, Neurologic and Immunologic Disorders, and Active Human Herpesvirus Type 6 Infection
Buchwald et al.
ANN INTERN MED 1992;116:103-113.
ABSTRACT  

Chronic Fatigue: A Prospective Clinical and Virologic Study
Gold et al.
JAMA 1990;264:48-53.
ABSTRACT  

Chronic Fatigue: Psyche or Sleep?-Reply
LANE et al.
Arch Intern Med 1990;150:1118-1121.
ABSTRACT  

The Frequency of the Chronic Fatigue Syndrome in Patients with Symptoms of Persistent Fatigue
Manu et al.
ANN INTERN MED 1988;109:554-556.
ABSTRACT  

Amantadine, Fatigue, and Multiple Sclerosis
Rosenberg and Appenzeller
Arch Neurol 1988;45:1104-1106.
ABSTRACT  

Chronic Fatigue in Primary Care: Prevalence, Patient Characteristics, and Outcome
Kroenke et al.
JAMA 1988;260:929-934.
ABSTRACT  

Chronic Fatigue Syndrome and the Diagnostic Utility of Antibody to Epstein-Barr Virus Early Antigen
Hellinger et al.
JAMA 1988;260:971-973.
ABSTRACT  

Chronic Fatigue Syndrome: A Working Case Definition
HOLMES et al.
ANN INTERN MED 1988;108:387-389.
ABSTRACT  

Granuloma Annulare-like Eruption due to Chronic Epstein-Barr Virus Infection
Spencer et al.
Arch Dermatol 1988;124:250-255.
ABSTRACT  

'Chronic Active Epstein-Barr Virus Infection'
Milbauer
JAMA 1987;258:907-907.
ABSTRACT  

EB or Not EB--That Is the Question
Straus
JAMA 1987;257:2335-2336.
ABSTRACT