K. De Meirleir, P. De Becker, I. Campine.
Human Physiology and Medicine
Vrije Universiteit Brussel, Brussels, Belgium
Blood Transfusion and Chronic Fatigue Syndrome
We analysed the data of 1210 consecutive patients complaining of chronic fatigue who visited our fatigue clinic at the Vrije Universiteit Brussel.
In this group, 752 patients fulfilled the CDC criteria for CFS (Fuduka, 1994). Of those CFS patients, 34 (4.5%) have a common factor in their past medical history that immediately preceded the onset of their CFS. These patients had received a blood transfusion a few days to a week prior to developing a 'flu-like syndrome that later proved to be the acute onset of their CFS. Another 8 patients also received a blood transfusion but their illness only started at least 2 months later, so that we cannot take these patients into our calculations.
None of these post-transfusion patients developed hepatitis C or other types of viral hepatitis. Some have antibodies (IgG) against CMV or EBV, but the development of these antibodies in time relationship to the blood transfusion could not be determined. In 9 of 34 patients the LMW RNaseL test was performed; in all 9 patients the low molecular RNaseL accounts for the upregulation of the total RNaseL enzyme activity. This 2-5A synthetase RNaseL pathway is activated in viral disorders.
These findings point towards a transmittable cause in this subset of CFS patients in which acute onset was temporally linked to blood transfusion. As viruses and possibly other micro-organisms seem to be able to trigger an acute onset of CFS and the fact that RNaseL dysfunction seems to be preferentially related to CFS, it comes as no real surprise that receivers of a blood transfusion, often being in a weakened health status, can develop CFS.
We therefore would advise CFS patients not to be blood donors and secondly that the administration of blood transfusions has to be very carefully considered and only be given when strictly necessary and not as a standard procedure after e.g. the delivery of a baby.
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