Evidence of clinical pathology abnormalities in people with Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome (ME/CFS) from an analytic cross-sectional study, by Luis Nacul, Barbara de Barros, Caroline C Kingdon, Jacqueline M Cliff, Taane G Clark, Kathleen Mudie, Hazel M Dockrell, Eliana M Lacerda in Diagnostics Vol 9, #2, p 41 [April 10, 2019]
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disease presenting with extreme fatigue, post-exertional malaise, and other symptoms. In the absence of a diagnostic biomarker, ME/CFS is diagnosed clinically, although laboratory tests are routinely used to exclude alternative diagnoses.
In this analytical cross-sectional study, we aimed to explore potential haematological and biochemical markers for ME/CFS, and disease severity. We reviewed laboratory test results from 272 people with ME/CFS and 136 healthy controls participating in the UK ME/CFS Biobank (UKMEB).
After corrections for multiple comparisons, most results were within the normal range, but people with severe ME/CFS presented with lower median values (p < 0.001) of serum creatine kinase (CK; median=54 U/L), compared to healthy controls (HCs; median=101.5 U/L) and non-severe ME/CFS (median=84 U/L). The differences in CK concentrations persisted after adjusting for sex, age, body mass index, muscle mass, disease duration, and activity levels (odds ratio (OR) for being a severe case=0.05 (95% confidence interval (CI)=0.02-0.15) compared to controls, and OR=0.16 (95% CI=0.07-0.40), compared to mild cases).
This is the first report that serum CK concentrations are markedly reduced in severe ME/CFS, and these results suggest that serum CK merits further investigation as a biomarker for severe ME/CFS.