Biochemical and vascular aspects of pediatric chronic fatigue syndrome.
OBJECTIVE
To evaluate the biochemical and vascular aspects of pediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME).


METHODS
Cross-sectional clinical study.


METHODS
Tayside, Scotland, United Kingdom.


METHODS
Twenty-five children with CFS/ME and 23 healthy children recruited from throughout the United Kingdom.


METHODS
Participants underwent a full clinical examination to establish a diagnosis of CFS/ME and were asked to describe and score their CFS/ME symptoms. Biochemical markers were measured. Arterial wave reflection was estimated to assess systemic arterial stiffness.


METHODS
Markers of oxidative stress and free radicals, C-reactive protein level, white blood cell apoptosis, and arterial wave reflection.


RESULTS
Children with CFS/ME had increased oxidative stress compared with control individuals (isoprostanes: 252.30 vs 215.60 pg/mL, P = .007; vitamin C, mean [SD]: 0.84 [0.26] vs 1.15 [0.28] mg/dL, P < .001; vitamin E, 8.72 [2.39] vs 10.94 [3.46] microg/mL, P = .01) and increased white blood cell apoptosis (neutrophils: 53.7% vs 35.7%, P = .005; lymphocytes: 40.1% vs 24.6%, P = .009). Arterial stiffness variables did not differ significantly between groups (mean augmentation index, -0.57% vs -0.47%, P = .09); however, the derived variables significantly correlated with total (r = 0.543, P = .02) and low-density lipoprotein (r = 0.631, P = .004) cholesterol in patients with CFS/ME but not in controls.


CONCLUSIONS
Biomedical anomalies seen in adults with CFS/ME-increased oxidative stress and increased white blood cell apoptosis-can also be observed in children with clinically diagnosed CFS/ME compared with matched controls. Unlike in their adult counterparts, however, arterial stiffness remained within the reference range in these pediatric patients.
Kennedy
Gwen
G
Vascular and Inflammatory Diseases Research Unit, The Institute of Cardiovascular Research, Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom. g.y.kennedy@dundee.ac.uk
Khan
Faisel
F
Hill
Alexander
A
Underwood
Christine
C
Belch
Jill J F
JJ
D000293:Adolescent; D000975:Antioxidants / Q000032:analysis; D017209:Apoptosis / Q000502:physiology; D001158:Arteries / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D003430:Cross-Sectional Studies; D004548:Elasticity; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005609:Free Radicals / Q000378:metabolism; D006439:Hemodynamics; D018056:Hemorheology; D006801:Humans; D028421:Isoprostanes / Q000097:blood; D008297:Male; D018384:Oxidative Stress
D000975:Antioxidants; D005609:Free Radicals; D028421:Isoprostanes; D002097:C-Reactive Protein