Eosinophil cationic protein serum levels & allergy in Chronic Fatigue Syndrome (CFS)

Chronic fatigue syndrome (CFS) is a syndrome of uncertain

etiopathogenesis characterized by disabling fatigue associated

with a variable number of somatic and/or neuropsychologic

symptoms. In patients with CFS, several immunologic

abnormalities can be detected, including a higher prevalance

of allergy. The aim of this study was to determine whether CFS

patients, well studied for their allergy profile, show signs

of eosinophil activation, as detectable by the measurement in

serum of eosinophil cationic protein (ECP) levels. In 35

consecutive CFS outpatients (diagnosis based on the Centers

for Disease Control case definition), ECP was measured in

serum by a competitive enzyme immunoassay (ECP-FEIA kit, Kabi

Pharmacia Diagnostics, Uppsala, Sweden). Fourteen disease-free

subjects with no history of CFS or allergy were selected as

controls. ECP serum levels were significantly higher in CFS

patients than in controls (18.0 +/- 11.3 micrograms/l vs 7.3

+/- 2.1 micrograms/l; P < 0.01).

In the CFS population, the

prevalence of RAST positivity to one or more allergens was

77%, while no control showed positive RAST. Twelve of the 14

CFS patients with increased ECP serum levels were

RAST-positive. However, CFS RAST-positive patients had no

significantly higher ECP serum levels than CFS RAST-negative

patients (19.3 +/- 12.4 micrograms/l vs 13.6 +/- 3.7

micrograms/l; P = 0.4). This is the first report of increased

serum levels of ECP in CFS. On the basis of the available

data, it is discussed whether eosinophil activation has a

pathogenetic role in CFS or is linked to the frequently

associated allergic condition, or, finally, whether a common

immunologic background may exist for both atopy and CFS.

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