Detection of mycotoxins in patients with chronic fatigue syndrome.
Level 4 - case-series / case-control
Case series with historical control group comparison
PubMed 23580077 · doi:10.3390/toxins5040605
What was done
Urine samples from 112 patients with a prior diagnosis of chronic fatigue syndrome (CFS) were tested for aflatoxins, ochratoxin A (OTA), and macrocyclic trichothecenes (MT) using Enzyme Linked Immunosorbent Assays (ELISA). Patients were evaluated for exposure to water-damaged buildings (WDB). Environmental testing was performed on WDBs from a subset of patients. Urine test results were compared to prior testing in 55 healthy control subjects without a history of WDB exposure using the same methods.
What was found
Urine specimens from 104 of 112 patients (93%) tested positive for at least one mycotoxin (including one in the equivocal range). Almost 30% of cases had multiple mycotoxins present. OTA was detected in 83% of cases and MT in 44%. Over 90% of cases reported current or past exposure to WDBs. Environmental testing in a subset confirmed mycotoxins and mycotoxin-producing mold species. Zero of the 55 historical healthy controls tested positive at the detection limits.
Why it matters
The study reports a high frequency of mycotoxin excretion in patients with CFS who have mold exposure histories. It highlights environmental mold toxins as a potential area of investigation in chronic fatigue pathophysiology.
Limits
The study used historical non-concurrent controls rather than a prospective matched control cohort. Mycotoxin detection relied solely on ELISA rather than mass spectrometry. Environmental testing was conducted only in a subset of patients, exposure history was self-reported, and the observational design cannot establish causality.
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