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Assessment of the 1994 CDC Definition

Recently, the CDC has very substantially improved its guidelines for the application of the 1994 CFS Criteria, and the Agency has stated it is reviewing the efficacy of more recent Diagnostic Criteria.

The CDC Criteria had very substantial flaws at its inception, so it is helpful to review both (1) some supplemental lab tests available to physicians for diagnostic purposes, and (2) the substantial limitations of the Criteria in accurately diagnosing ME/CFS.

Other Laboratory testing: Given more recent research and clinical experience, as well as the Social Security Administration Ruling on CFS, 2014, other tests may be indicative of CFS. A number CFS expert researchers and clinicians have developed protocols of laboratory and other tests that are helpful in adding confirmatory weight to a ME/CFS diagnosis. These tests are not directly diagnostic; however, in a percentage of cases they can positively contribute to a diagnosis after all other steps are taken under various diagnostic criteria.

It should be noted that in other sections of this website are references to various recent papers which provide evidence of viral and other microbial involvement in ME/CFS. Experienced clinicians and researchers are beginning to make use of various tests to determine the presence of active virus, including EBV, CMV, HHV-6, as well as other microbes. Clinicians certainly can run the protocols below as part of their effort to diagnose ME/CFS.

Dr. Anthony Komaroff, a leading specialist in ME/CFS cites the following laboratory abnormalities as supportive of a ME/CFS diagnosis:

Laboratory Abnormalities and Chronic Viral Fatigue Syndrome (CFS)*:

  • Mild leukopenia (3000-5000/mm)
  • Moderate monocytosis (7%-15%)
  • Relative lymphocytosis (>40%)
  • Atypical lymphocytosis (1%-20%)
  • Slight elevation in SGOT and SGPT
  • Erythrocyte sedimentation rate unusually low (0-4mm)
  • Partial reduction in immunoglobulins
  • Circulating immune complexes (low levels)
  • Increased CD4/CD8 ratio
  • EBV antibodies:

Viral capsid antigen-IgG > 1:640
Viral capsid antigen-IgM-not detectable
Early antigen- 1:40
EB nuclear antigen <1:5

*It is unusual for more than one or two of these findings to be present in any single patient.