Child's Nervous System

, Volume 32, Issue 3, pp 475–483 | Cite as

A cross-sectional study of carnitine deficiency and fatigue in pediatric cancer patients

  • Jin-Shei LaiEmail author
  • Tracy Haertling
  • Joanna Weinstein
  • Alfred W. Rademaker
  • Stewart Goldman
Original Paper



Carnitine deficiency has been found in cancer patients and has been associated with fatigue. This study aimed to explore the prevalence of carnitine deficiency in pediatric cancer patients and its relationship with fatigue and other potential contributing factors.


Children with cancer or Langerhans cell histiocytosis who were receiving treatment or had completed therapy were eligible. Patients completed the Pediatric Functional Assessment of Chronic Illness-Fatigue, the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, a numeric fatigue rating, and had carnitine levels obtained. Carnitine deficiency was defined as a total and/or free carnitine level less than normal for age or an acylcarnitine value higher than normal for age.


Data from 142 children aged 8–17 were analyzed. Twenty-eight of 142 (19.7 %) had decreased total and 42.8 % (12/28) had decreased free carnitine levels. No patients had elevated acylcarnitine levels or elevated ratios. Patients with versus without carnitine deficiency differed by age (p = 0.043), treatment (p = 0.037), duration since last chemotherapy (p = 0.020), and body mass index (p = 0.010), but not fatigue, when all data were analyzed together. Yet, a negative relationship between fatigue and carnitine levels was found on a subgroup (off-therapy; fatigue worse than the norm).


No significant association between fatigue and carnitine level was demonstrated when data from all patients were analyzed together; however, a significant yet unexpected relationship was found for patients who completed therapy and reported elevated fatigue. Given the small sample size, these results should be interpreted with caution. Future studies to explore impact upon excessive carnitine levels are warranted.


Carnitine Fatigue Cancer Children 



Dr. Haertling’s efforts were supported by a grant from the SurvivorVision when she was on fellowship at Ann & Robert H. Lurie Children’s Hospital of Chicago. We also thank Kara Halligan, RN, for her assistance in patient recruitment and enrollment.

Compliance with ethical standards

Conflict of interest statement

The authors declare that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding source

Dr. Haertling’s efforts were supported by a grant from the SurvivorVision when she was on fellowship at Ann & Robert H. Lurie Children’s Hospital of Chicago.

Supplementary material

381_2015_2983_MOESM1_ESM.doc (303 kb)
ESM 1 (DOC 303 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jin-Shei Lai
    • 1
    Email author
  • Tracy Haertling
    • 2
  • Joanna Weinstein
    • 3
  • Alfred W. Rademaker
    • 4
  • Stewart Goldman
    • 5
  1. 1.Department of Medical Social Sciences and PediatricsNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Memorial Hospital of South BendSouth BendUSA
  3. 3.Ann & Robert H. Lurie Children’s Hospital of ChicagoNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  5. 5.Ann & Robert H. Lurie Children’s Hospital of ChicagoNorthwestern University Feinberg School of Medicine ChicagoChicagoUSA

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