Chronic fatigue syndrome after infectious mononucleosis in adolescents
Open accessAbstract
OBJECTIVE: The goal was to characterize prospectively the course and outcome of chronic fatigue syndrome in adolescents during a 2-year period after infectious mononucleosis. METHODS: A total of 301 adolescents (12-18 years of age) with infectious mononucleosis were identified and screened for nonrecovery 6 months after infectious mononucleosis by using a telephone screening interview. Nonrecovered adolescents underwent a medical evaluation, with follow-up screening 12 and 24 months after infectious mononucleosis. After blind review, final diagnoses of chronic fatigue syndrome at 6, 12, and 24 months were made by using established pediatric criteria. RESULTS: Six, 12, and 24 months after infectious mononucleosis, 13%, 7%, and 4% of adolescents, respectively, met the criteria for chronic fatigue syndrome. Most individuals recovered with time; only 2 adolescents with chronic fatigue syndrome at 24 months seemed to have recovered or had an explanation for chronic fatigue at 12 months but then were reclassified as having chronic fatigue syndrome at 24 months. All 13 adolescents with chronic fatigue syndrome 24 months after infectious mononucleosis were female and, on average, they reported greater fatigue severity at 12 months. Reported use of steroid therapy during the acute phase of infectious mononucleosis did not increase the risk of developing chronic fatigue syndrome. CONCLUSIONS: Infectious mononucleosis may be a risk factor for chronic fatigue syndrome in adolescents. Female gender and greater fatigue severity, but not reported steroid use during the acute illness, were associated with the development of chronic fatigue syndrome in adolescents. Additional research is needed to determine other predictors of persistent fatigue after infectious mononucleosis.
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Women are at higher risk of ME/CFS than men.
“Since women are at higher risk of ME/CFS than men5,18, it is thought that female sex hormones play an important role in the onset, persistence, and symptom burden of this illness19.”
From Leveraging Prior Knowledge of Endocrine Immune Regulation in the Therapeutically-relevant Phenotyping of Women with Chronic Fatigue Syndrome (2019) · cites this paper as [5]
The Results report that 35 of 39 adolescents with CFS six months after infectious mononucleosis were female, and the Discussion says females may be at particular risk. This supports a sex difference in the studied post-infection adolescent cohort, but not the broader claim that women generally have a higher risk of ME/CFS than men. (LLM, conf=0.85)
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- Authors
- Katz, B. Z., Shiraishi, Y., Mears, C. J., Binns, H. J., & Taylor, R.
- Affiliations
- Northwestern University (US)
- University of Illinois Chicago (US)
- Department of Occupational Health, College of Applied Sciences, University of Illinois at Chicago, Chicago, Illinois
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2009-07-01
- Volume
- 124
- Issue
- 1
- Pages
- 189-193
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC2756827
- OpenAlex
- W2021748243
- Cited by
- 221
- References
- 19
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 23 · 2023: 25 · 2022: 26 · 2021: 19 · 2020: 11 · 2019: 18 · 2018: 10 · 2017: 11 · 2016: 12 · 2015: 4 · 2014: 11 · 2013: 4 · 2012: 8
- FWCI
- 4.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- University of Illinois at Urbana-Champaign
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD043301, R01HD4330101A1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Oncology › Viral-associated cancers and disorders
- Keywords
- chronic fatigue syndrome, infectious mononucleosis, adolescents, persistent fatigue, corticosteroid therapy, female sex, fatigue severity, risk factors, post-infectious fatigue
- MeSH terms
- Adolescent, Child, Female, Humans, Infectious Mononucleosis, Male, Risk Factors, Fatigue Syndrome, Chronic
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