Enteroviral RNA sequences detected by polymerase chain reaction in muscle of patients with postviral fatigue syndrome.
OBJECTIVE
To determine the presence of enteroviral sequences in muscle of patients with the postviral fatigue syndrome.


METHODS
Detection of sequences with the polymerase chain reaction in a well defined group of patients with the syndrome and controls over the same period.


METHODS
Institute of Neurological Sciences, Glasgow.


METHODS
60 consecutive patients admitted to the institute with the postviral fatigue syndrome who had undergone extensive investigation to exclude other conditions. 41 controls from the same catchment area without evidence of fatigue, all undergoing routine surgery.


METHODS
Routine investigations, serological screen for antibodies to a range of viruses, and presence of enteroviral RNA sequences in muscle biopsy specimens.


RESULTS
15 (25%) patients and 10 (24.4%) controls had important serological findings. 12 patients had neutralising antibody titres of greater than or equal to 256 to coxsackieviruses B1-5 (six positive for enteroviral RNA sequences, six negative); three were positive for Epstein-Barr virus specific IgM (two positive, one negative). Six controls had similar neutralising antibody titres to coxsackieviruses (all negative); one was positive for Epstein-Barr virus specific IgM (negative); and three had titres of complement fixing antibody greater than or equal to 256 to cytomegalovirus (all negative). Overall, significantly more patients than controls had enteroviral RNA sequences in muscle (32/60, 53% v 6/41, 15%; odds ratio 6.7, 95% confidence interval 2.4 to 18.2). This was not correlated with duration of disease, patient and age, or to raised titres of antibodies to coxsackieviruses B1-5.


CONCLUSIONS
Persistent enteroviral infection of muscle may occur in some patients with postviral fatigue syndrome and may have an aetiological role.
Gow
J W
JW
Department of Neurology, University of Glasgow.
Behan
W M
WM
Clements
G B
GB
Woodall
C
C
Riding
M
M
Behan
P O
PO
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D001483:Base Sequence; D004770:Enterovirus / Q000235:genetics* / Q000276:immunology; D004769:Enterovirus Infections / Q000150:complications / Q000276:immunology; D015673:Fatigue Syndrome, Chronic / Q000209:etiology / Q000276:immunology / Q000382:microbiology*; D005260:Female; D005784:Gene Amplification; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009132:Muscles / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis*
D000914:Antibodies, Viral; D012367:RNA, Viral