title: Detection of mycotoxins in patients with chronic fatigue syndrome.
abstract: Over the past 20 years, exposure to mycotoxin producing mold has been recognized as a significant health risk. Scientific literature has demonstrated mycotoxins as possible causes of human disease in water-damaged buildings (WDB). This study was conducted to determine if selected mycotoxins could be identified in human urine from patients suffering from chronic fatigue syndrome (CFS). Patients (n = 112) with a prior diagnosis of CFS were evaluated for mold exposure and the presence of mycotoxins in their urine. Urine was tested for aflatoxins (AT), ochratoxin A (OTA) and macrocyclic trichothecenes (MT) using Enzyme Linked Immunosorbent Assays (ELISA). Urine specimens from 104 of 112 patients (93%) were positive for at least one mycotoxin (one in the equivocal range). Almost 30% of the cases had more than one mycotoxin present. OTA was the most prevalent mycotoxin detected (83%) with MT as the next most common (44%). Exposure histories indicated current and/or past exposure to WDB in over 90% of cases. Environmental testing was performed in the WDB from a subset of these patients. This testing revealed the presence of potentially mycotoxin producing mold species and mycotoxins in the environment of the WDB. Prior testing in a healthy control population with no history of exposure to a WDB or moldy environment (n = 55) by the same laboratory, utilizing the same methods, revealed no positive cases at the limits of detection.
authors.affiliation: Plaza Infectious Disease and St. Luke's Hospital, 4320 Wornall Road, Suite 440, Kansas City, MO 64111, USA. jbrewer@plazamedicine.com
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Brewer
authors.forename: Jack D
authors.initials: JD
authors.lastname: Thrasher
authors.forename: David C
authors.initials: DC
authors.lastname: Straus
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Madison
authors.forename: Dennis
authors.initials: D
authors.lastname: Hooper
mesh_terms: D000293:Adolescent; D000328:Adult; D000348:Aflatoxins / Q000378:metabolism / Q000633:toxicity / Q000652:urine; D000368:Aged; D003252:Construction Materials / Q000382:microbiology*; D018876:Environmental Illness / Q000139:chemically induced* / Q000378:metabolism / Q000652:urine; D004783:Environmental Microbiology; D004797:Enzyme-Linked Immunosorbent Assay; D005192:Family Health; D015673:Fatigue Syndrome, Chronic / Q000139:chemically induced* / Q000378:metabolism / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D005658:Fungi / Q000254:growth & development / Q000302:isolation & purification* / Q000378:metabolism; D006801:Humans; D057230:Limit of Detection; D008297:Male; D008875:Middle Aged; D008928:Mitochondria / Q000187:drug effects / Q000378:metabolism; D009183:Mycotoxins / Q000378:metabolism / Q000633:toxicity* / Q000652:urine; D009793:Ochratoxins / Q000378:metabolism / Q000633:toxicity / Q000652:urine; D014255:Trichothecenes / Q000378:metabolism / Q000633:toxicity / Q000652:urine; D055815:Young Adult
chemical_list: D000348:Aflatoxins; D009183:Mycotoxins; D009793:Ochratoxins; D014255:Trichothecenes; C025589:ochratoxin A