To the Editor.—
Hellinger et al1 state that "the validity of the chronic mononucleosis syndrome and the appropriate means for its diagnosis have not been established." I would like to add a proviso.
Since there were no data presented in this study that either prove or disprove the "validity" of the syndrome itself, the authors should refrain from drawing such a conclusion. This article only addresses the value of Epstein-Barr virus serology in the diagnosis of chronic mononucleosis, also known as chronic fatigue syndrome. Others have reached similar conclusions in the past.2
These results could be interpreted to show that the testing available today is simply not sensitive enough to help diagnose this illness. They also suggest that laboratory testing for chronic fatigue syndrome, in itself, is no substitute for careful history taking, examination, and differential diagnosis.
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