Published online July 2, 2007
PEDIATRICS Vol. 120 No. 1 July 2007, pp. e129-e137 (doi:10.1542/peds.2006-2759)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wyller, V. B.
Right arrow Articles by Walløe, L.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Wyller, V. B.
Right arrow Articles by Walløe, L.
Related Collections
Right arrow Adolescent Medicine
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Abnormal Thermoregulatory Responses in Adolescents With Chronic Fatigue Syndrome: Relation to Clinical Symptoms

Vegard Bruun Wyller, MDa,b, Kristin Godang, BScc, Lars Mørkrid, MD, PhDd, Jerome Philip Saul, MDe, Erik Thaulow, MD, PhDa and Lars Walløe, MD, PhDb

a Departments of Pediatrics
c Endocrinology
d Medical Biochemistry, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway
b Department of Physiology, University of Oslo, Oslo, Norway
e Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina

OBJECTIVES. Chronic fatigue syndrome is a common and disabling disease of unknown etiology. Accumulating evidence indicates dysfunction of the autonomic nervous system. To further explore the pathophysiology of chronic fatigue syndrome, we investigated thermoregulatory responses dependent on catecholaminergic effector systems in adolescent patients with chronic fatigue syndrome.

PATIENTS AND METHODS. A consecutive sample of 15 patients with chronic fatigue syndrome aged 12 to 18 years and a volunteer sample of 57 healthy control subjects of equal gender and age distribution were included. Plasma catecholamines and metanephrines were measured before and after strong cooling of 1 hand. Acral skin blood flow, tympanic temperature, heart rate, and mean blood pressure were measured during moderate cooling of 1 hand. In addition, clinical symptoms indicative of thermoregulatory disturbances were recorded.

RESULTS. Patients with chronic fatigue syndrome reported significantly more shivering, sweating, sudden change of skin color, and feeling unusually warm. At baseline, patients with chronic fatigue syndrome had higher levels of norepinephrine, heart rate, epinephrine, and tympanic temperature than control subjects. During cooling of 1 hand, acral skin blood flow was less reduced, vasoconstrictor events occurred at lower temperatures, and tympanic temperature decreased more in patients with chronic fatigue syndrome compared with control subjects. Catecholamines increased and metanephrines decreased similarly in the 2 groups.

CONCLUSIONS. Adolescent patients with chronic fatigue syndrome have abnormal catecholaminergic-dependent thermoregulatory responses both at rest and during local skin cooling, supporting a hypothesis of sympathetic dysfunction and possibly explaining important clinical symptoms.

Key Words: chronic fatigue • thermal regulation • adolescents • pathogenesis

Abbreviations: CFS—chronic fatigue syndrome • AVA—arteriovenous anastomosis • CDC—Centers for Disease Control and Prevention • ASBF—acral skin blood flow • TT—tympanic temperature • HR—heart rate • MBP—mean blood pressure • CI—confidence interval

Accepted Jan 25, 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?