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The Epstein-Barr Virus and Chronic Fatigue Syndrome FREE

George R. Reiss, MD
JAMA. 1989;261(9):1278-1278. doi:10.1001/jama.1989.03420090041018
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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.2These 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.

REFERENCES

Hellinger WC, Smith TF, Van Scoy RE, et al:  Chronic fatigue syndrome and the diagnostic utility of antibody to Epstein-Barr virus early antigen . JAMA 1988;;260:971-973.
Merlin T:  Chronic mononucleosis: Pitfalls in the laboratory diagnosis . Hum Pathol 1986;;17:2-8.
Acheson ED:  The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland disease and epidemic neuromyasthenia . Am J Med 1959;;26:569-595.
Holmes GP, Kaplan JE, Stewart JA, et al:  A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause? JAMA 1987;;257:2297-2302.
Straus SE, Tosato G, Armstrong G, et al:  Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection . Ann Intern Med 1985;;102:7-16.

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Hellinger WC, Smith TF, Van Scoy RE, et al:  Chronic fatigue syndrome and the diagnostic utility of antibody to Epstein-Barr virus early antigen . JAMA 1988;;260:971-973.
Merlin T:  Chronic mononucleosis: Pitfalls in the laboratory diagnosis . Hum Pathol 1986;;17:2-8.
Acheson ED:  The clinical syndrome variously called benign myalgic encephalomyelitis, Iceland disease and epidemic neuromyasthenia . Am J Med 1959;;26:569-595.
Holmes GP, Kaplan JE, Stewart JA, et al:  A cluster of patients with a chronic mononucleosis-like syndrome. Is Epstein-Barr virus the cause? JAMA 1987;;257:2297-2302.
Straus SE, Tosato G, Armstrong G, et al:  Persisting illness and fatigue in adults with evidence of Epstein-Barr virus infection . Ann Intern Med 1985;;102:7-16.
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