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Cited by 384

The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.

A Chronic Illness Characterized by Fatigue, Neurologic and Immunologic Disorders, and Active Human Herpesvirus Type 6 Infection

Buchwald, Dedra, Cheney, Paul R., Peterson, Daniel L., Henry, Berch, Wormsley, Susan B., Geiger, Ann, Ablashi, Dharam V., Salahuddin, S. Zaki, Saxinger, Carl, Biddle, Royce, Kikinis, Ron, Jolesz, Ferenc A., Folks, Thomas, Balachandran, N., Peter, James B., Gallo, Robert C., Komaroff, Anthony L.·1992·Annals of Internal Medicine
DOI 10.7326/0003-4819-116-2-103
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Abstract

OBJECTIVE: To conduct neurologic, immunologic, and virologic studies in patients with a chronic debilitating illness of acute onset. DESIGN: Cohort study with comparison to matched, healthy control subjects. PATIENTS: We studied 259 patients who sought care in one medical practice; 29% of the patients were regularly bedridden or shut-in. MAIN OUTCOME MEASURES: Detailed medical history, physical examination, conventional hematologic and chemistry testing, magnetic resonance imaging (MRI) studies, lymphocyte phenotyping studies, and assays for active infection of patients' lymphocytes with human herpesvirus type 6 (HHV-6). MAIN RESULTS: Patients had a higher mean (+/- SD) CD4/CD8 T-cell ratio than matched healthy controls (3.16 +/- 1.5 compared with 2.3 +/- 1.0, respectively; P less than 0.003). Magnetic resonance scans of the brain showed punctate, subcortical areas of high signal intensity consistent with edema or demyelination in 78% of patients (95% CI, 72% to 86%) and in 21% of controls (CI, 11% to 36%) (P less than 10(-9)). Primary cell culture of lymphocytes showed active replication of HHV-6 in 79 of 113 patients (70%; CI, 61% to 78%) and in 8 of 40 controls (20%; CI, 9% to 36%) (P less than 10(-8], a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA. CONCLUSIONS: Neurologic symptoms, MRI findings, and lymphocyte phenotyping studies suggest that the patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system. The active replication of HHV-6 most likely represents reactivation of latent infection, perhaps due to immunologic dysfunction. Our study did not directly address whether HHV-6, a lymphotropic and gliotropic virus, plays a role in producing the symptoms or the immunologic and neurologic dysfunction seen in this illness. Whether the findings in our patients, who came from a relatively small geographic area, will be generalizable to other patients with a similar syndrome remains to be seen.

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Metadata

Authors
Buchwald, D., Cheney, P. R., Peterson, D. L., Henry, B., Wormsley, S. B., Geiger, A., Ablashi, D. V., Salahuddin, S. Z., Saxinger, C., Biddle, R., Kikinis, R., Jolesz, F. A., Folks, T., Balachandran, N., Peter, J. B., Gallo, R. C., & Komaroff, A. L.
Venue
Annals of Internal Medicine
Publisher
American College of Physicians
Published
1992-01-15
Volume
116
Issue
2
Pages
103-113
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
DOI
10.7326/0003-4819-116-2-103
OpenAlex
W2149522551
Cited by
384
References
53
FWCI
29.54
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: A Chronic Illness Characterized by Fatigue, Neurologic and Immunologic Disorders, and Active Human Herpesvirus Type 6 Infection. https://app.cochat.ai/papers/10.7326/0003-4819-116-2-103
The paper
Buchwald, D., Cheney, P. R., Peterson, D. L., Henry, B., Wormsley, S. B., Geiger, A., Ablashi, D. V., Salahuddin, S. Z., Saxinger, C., Biddle, R., Kikinis, R., Jolesz, F. A., Folks, T., Balachandran, N., Peter, J. B., Gallo, R. C., & Komaroff, A. L. (1992). A Chronic Illness Characterized by Fatigue, Neurologic and Immunologic Disorders, and Active Human Herpesvirus Type 6 Infection. Annals of Internal Medicine. https://doi.org/10.7326/0003-4819-116-2-103

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.