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Blood Volume Status in Patients with Chronic Fatigue Syndrome

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is amongst others characterized by a persistent severe fatigue, diminished exercise tolerance, post exertional malaise, muscle pain, sleep disorders and memory and concentration impairment. Furthermore, a prominent feature is that patients with ME/CFS often complain about dizziness and/or light headedness both while exercising and at rest.

Four studies have compared a possible decrease in circulating blood volume in Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients when compared to a healthy population. A more recent study has proven a correlation between RBC volume and OI in chronic OI patients without being diagnosed ME/CFS. The aim of the present study was to relate measured blood, RBC and plasma volumes (absolute and percent normalized) with the orthostatic intolerance complaints in ME/CFS patients.

Eleven female ME/CFS patients were studied from early 2010 till early 2011. Patients underwent the standard dual isotope erythrocyte labelling technique to determine blood volume, erythrocyte and plasma volume. Volumes were also expressed as absolute values (total and per kg body weight). Scores were tested for normal distribution using the Shapiro Wilk test in SPSS.

The results showed that in the included 11 female ME/CFS patients, percentage decrease in normalized blood, RBC and plasma volume was similar for all three components: 83% ± 12%, 83% ±12% and 83% ± 11%, respectively. In patients with a clinical suspicion of OI (n = 7) all 3 volume components were significantly lower compared to patients without clinical suspicion of OI (n = 4). The difference percentage to normalized Blood volume was 77(7) vs 94(10) (p-value < 0.02), difference percentage to normalized RBC volume was 76(7) vs 96(10) (p-value < 0.01) and difference percentage to normalized plasma volume was 77(7) vs 93(10) (p-value < 0.05) in OI present versus absent. Plasma volumes were plotted against RBC volumes: the relation found was RBC volume = 0.99* Plasma volume + 1.55; p < 0.001; r = 0.90.

In conclusion, in line with data in previous literature, this pilot shows that total blood volume and its components: RBC and plasma volume may be reduced in CFS patients and confirms the finding that a relation between blood volume and percentage predicted peak VO2 was present.


Article by C. (Linda) M. C. van Campen and Frans C. Visser, from Stichting CardioZorg, Hoofddorp, The Netherlands.


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