The Indian Journal of Pediatrics

, Volume 79, Issue 1, pp 52–55

Factors Affecting Duration of Chronic Fatigue Syndrome in Pediatric Patients

  • Dmitriy Petrov
  • Daniel Marchalik
  • Michael Sosin
  • Aswine Bal
Original Article



To determine factors affecting duration of chronic fatigue syndrome (CFS) in pediatric patients.


This Retrospective cohort consisted of patients with CFS at the regional referral infectious disease clinic for evaluation of fatigue in children and adolescents. Demographic, clinical, and laboratory data were analyzed to identify the impact on duration and severity of pediatric CFS.


A total number of 53 predominantly white (98.1%) patients with CFS, aged 9–18 years, were included in the study. Other than fatigue, headaches and sleep disturbance were the most common symptoms of pediatric CFS. Seropositive status for Borrelia burgdorferi (B. burgdorferi) and Epstein-Barr virus (EBV) was identified in 66% of the patients with the diagnosis of CFS by CDC criteria. No association was found between the CFS symptoms, gender, or age at diagnosis and duration of fatigue symptoms. Duration of CFS was associated with high Body-Mass Index (BMI) in a regression model after adjustment for patient’s age, gender, and seropositive status for B. burgdorferi and/or EBV (0.34 ± 0.15, P < 0.04).


BMI is significantly associated with prolonged duration of CFS.


Children and adolescents Chronic fatigue syndrome Risk factors 


  1. 1.
    Prins JB, van der Meer JW, Bleijenberg G. Chronic fatigue syndrome. Lancet. 2006;367:346–55.PubMedCrossRefGoogle Scholar
  2. 2.
    Marshall GS. Report of a workshop on the epidemiology, natural history, and pathogenesis of chronic fatigue syndrome in adolescents. J Pediatr. 1999;134:395–405.PubMedCrossRefGoogle Scholar
  3. 3.
    Miike T, Tomoda A, Jhodoi T, Iwatani N, Mabe H. Learning and memorization impairment in childhood chronic fatigue syndrome manifesting as school phobia in Japan. Brain Dev. 2004;26:442–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Gill AC, Dosen A, Ziegler JB. Chronic fatigue syndrome in adolescents A Follow-up Study. Arch Pediatr Adolesc Med. 2004;158:225–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Jordan KM, Landis DA, Downey MC, et al. Chronic fatigue syndrome in children and adolescents: a review. J Adolesc Health. 1998;22:4–18.PubMedCrossRefGoogle Scholar
  6. 6.
    Sankey CM, Brown J, Quinn L, Quinn L, Fletcher A. A follow-up study of chronic fatigue syndrome in children and adolescents: symptom persistence and school absenteeism. Clin Child Psycho Psychiatry. 2006;11:126–38.CrossRefGoogle Scholar
  7. 7.
    Rangel L, Garralda ME, Levin M, Roberts H. The course of severe chronic fatigue syndrome in childhood. J R Soc Med. 2000;93:129.PubMedGoogle Scholar
  8. 8.
    Bell KM, Cookfair D, Bell DS, Reese P, Cooper L. Risk factors associated with chronic fatigue syndrome in a cluster of pediatric cases. Rev Infect Dis. 1991;13:S32–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Straus SE. The chronic mononucleosis syndrome. J Infect Dis. 1988;157:405–12.PubMedCrossRefGoogle Scholar
  10. 10.
    Straus SE, Komaroff AL, Wedner HJ. Chronic fatigue syndrome: point and counterpoint. J Infect Dis. 1994;170:1–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Smith MS, Mitchell J, Corey L, et al. Chronic fatigue in adolescents. Pediatrics. 1991;88:195–202.PubMedGoogle Scholar
  12. 12.
    Katz BZ, Shiraishi Y, Mears CJ, Binns HJ, Taylor R. Chronic fatigue syndrome after infectious mononucleosis in adolescents. Pediatrics. 2009;124:189–93.PubMedCrossRefGoogle Scholar
  13. 13.
    Marshall GS, Gesser RM, Yamanish K, Starr SE. Chronic fatigue in children: clinical features, Epstein-Barr virus and human herpes virus 6serology and long term follow-up. Pediatr Infect Dis J. 1991;10:287–90.PubMedCrossRefGoogle Scholar
  14. 14.
    Bell DA, Jordan K, Robinson M. Thirteen-year follow-up of children and adolescents with chronic fatigue syndrome. Pediatrics. 2001;107:994–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Fukuda K, Straus SE, Hickie I, et al. The chronic fatigue syndrome: a comprehensive approach to its definition and study. International Chronic Fatigue Syndrome Study Group. Ann Intern Med. 1994;121:953–9.PubMedGoogle Scholar
  16. 16.
  17. 17.
    Plioplys AV. Experience and reason: Chronic fatigue syndrome should not be diagnosed in children. Pediatrics. 1997;100:270–1.PubMedCrossRefGoogle Scholar
  18. 18.
    Garralda ME, Rangel L. Impairment and coping in children and adolescents with chronic fatigue syndrome: a comparative study with other paediatric disorders. J Child Psychol Psychiatry. 2004;45:543–52.PubMedCrossRefGoogle Scholar
  19. 19.
    van de Putte EM, Uiterwaal CS, Bots ML, et al. Is chronic fatigue syndrome a connective tissue disorder? A cross-sectional study in adolescents. Pediatrics. 2005;115:e415–22.PubMedCrossRefGoogle Scholar
  20. 20.
    Garralda ME, Rangel L. Annotation: chronic fatigue syndrome in children and adolescents. J Child Psychol Psychiatry. 2002;43:169–76.PubMedCrossRefGoogle Scholar
  21. 21.
    Garralda ME, Rangel L. Chronic fatigue syndrome of childhood. Comparative study with emotional disorders. Eur Child Adolesc Psychiatry. 2005;14:424–30.PubMedCrossRefGoogle Scholar
  22. 22.
    Krilov LR, Fisher M, Friedman SB, Reitman D, Mandel FS. Course and outcomes of chronic fatigue in children and adolescents. Pediatrics. 1998;102:360–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Viner R, Hotopf M. Childhood predictors of self reported chronic fatigue syndrome/myalgic encephalomyelitis in adults: national birth cohort study. BMJ. 2004;329:941.PubMedCrossRefGoogle Scholar
  24. 24.
    Lloyd AR, Hickie I, Boughton CR, et al. Prevalence of chronic fatigue syndrome in an Australian population. Med J Aust. 1990;153:522–8.PubMedGoogle Scholar
  25. 25.
    Bell DS. Diagnosis of chronic fatigue syndrome in children and adolescents: special considerations. J Chr Fatigue Synd. 1995;1:29–36.CrossRefGoogle Scholar
  26. 26.
    Rimes KA, Goodman R, Hotopf M, et al. Incidence, prognosis, and risk factors for fatigue and chronic fatigue syndrome in adolescents: A Prospective Community Study. Pediatrics. 2007;119:e603–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Hutchinson A. A Report of the CFS/ME Working Group: report to the Chief Medical Officer of an Independent Working Group. 2002; 1–81.Google Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2011

Authors and Affiliations

  • Dmitriy Petrov
    • 1
  • Daniel Marchalik
    • 1
  • Michael Sosin
    • 1
  • Aswine Bal
    • 2
  1. 1.UMDNJ/Robert Wood Johnson Medical SchoolNew BrunswickUSA
  2. 2.Department of PediatricsJersey Shore University Medical CenterNeptuneUSA

Personalised recommendations