Summary
We have examined the muscle biopsies of 50 patients who had postviral fatigue syndrome (PFS) for from 1 to 17 years. We found mild to severe atrophy of type II fibres in 39 biopsies, with a mild to moderate excess of lipid. On ultrastructural examination, 35 of these specimens showed branching and fusion of mitochondrial cristae. Mitochondrial degeneration was obvious in 40 of the biopsies with swelling, vacuolation, myelin figures and secondary lysosomes. These abnormalities were in obvious contrast to control biopsies, where even mild changes were rarely detected. The findings described here provide the first evidence that PFS may be due to a mitochondrial disorder precipitated by a virus infection.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Acheson ED (1959) The clinical sydrome variously called benign myalgic encephalomyelitis, Iceland disease and epidemic neuromyasthenia. Am J Med 26:569–595
Archard LC, Bowles NE, Behan PO, et al (1988) Postviral fatigue syndrome: persistence of enterovirus RNA in muscle and elevated creatine kinase. J R Soc Med 81:326–329
Archard LC, Peters J, Behan PO, et al (1988) Detection of Epstein-Barr virus DNA in muscle from patients with postviral chronic fatigue syndrome, myalgic encephalomyelitis. J Exp Clin Cancer Res 7:3 [Suppl]
Arnold DL, Radda GK, Bore PJ, et al (1984) Excessive intracellular acidosis of skeletal muscle on exercise in a patient with postviral exhaustion/fatigue syndrome. Lancet 1:1367–1369
Astrom E, Friman G, Pilstrom L (1976) Effects of viral and mycoplasma infections on ultrastructure and enzyme activities in human skeletal muscle. Acta Pathol Microbiol Scand 84:113–122
Behan PO, Behan WMH (1988) Postviral fatigue syndrome. CRC Crit Rev Neurobiol 4:157–178
Byrne E, Trounce I, Dennett X (1985) Chronic relapsing myalgia (?postviral): clinical histological and biochemical studies. Aust N Z J Med 15:305–308
Calder BD, Warnock PJ, McCartney RA, Bell EJ (1987) Coxsackie B viruses and the post-viral fatigue syndrome: a prospective study in general practice. J R Coll Gen Pract 37:11–14
Cullen MJ, Mastaglia FL (1982) Pathological reactions of skeletal muscle. In: Mastaglia FL, Walton J (eds) Skeletal muscle pathology. Churchill Livingstone, London, pp 88–139
Dillon MJ, Marshall WC, Dudgeon JA, et al (1974) Epidemic neuromyasthenia: outbreak among nurses at a children's hospital. Br Med J 1:301–305
Di Mauro S, Bonilla E, Zevioni M, Nakagawa M, DeVivo D (1985) Mitochondrial myopathies. Ann Neurol 17:521–538
Dubowitz V (1985) The procedure of muscle biopsy and histological and histochemical stains and reactions. In: Muscle biopsy, 2nd edn. Balliere Tindall, London, pp 3–40
Fegan KG, Behan PO, Bell EJ (1983) Myalgic encephalomyelitis — report of an epidemic. J R Coll Gen Pract 33:335–337
Ghadially FN (1988) Mitochondria. In: Ultrastructural pathology of the cell and matrix, 3rd edn. Butterworths, London, pp 240–249
Gow J, Behan WMH, Clements GB, Woodall C, Riding M, Behan PO (1991) Enteroviral RNA sequences detected by polymerase chain reaction in muscle of patients with postviral fatigue syndrome. Br Med J 302:692–696
Hammersen F, Gidlof A, Larsson J, Lewis DH (1980) The occurrence of paracrystalline mitochondrial inclusions in normal human skeletal muscle. Acta Neuropathol (Berl) 49:35–41
Henderson DA, Shelokov A (1959) Epidemic neuromyasthenia: clinical syndrome? N Engl J Med 260:757–764
Holmes GP, Kaplan JE, Gantz NM, et al (1988) Chronic fatigue syndrome: a working case definition. Ann Intern Med 108:387–389
Innes SGB (1970) Encephalomyelitis resembling benign myalgic encephalomyelitis. Lancet I:969–971
Jamal GA, Hansen S (1989). Electrophysiological studies in the post-viral fatigue syndrome. J Neurol Neurosurg Psychiatry 48:691–694
Jamal GA, Hansen S (1989) Post-viral fatigue syndrome: evidence for underlying organic disturbance in the muscle fibre. Eur Neurol 29:272–276
Kamieniecka Z, Schmalbruch H (1980) Neuromuscular disorders with abnormal mitochondria. Int Rev Cytol 65:321–357
Miller NA, Carmichael HA, Calder BD, Behan PO, Bell EJ, McCartney RA (1991) Antibody to Coxsackie B virus in diagnosing postviral fatigue syndrome. Br Med J 302:140–143
Moraes CT, di Mauro S, Zeviani M et al (1989) Mitochondrial DNA deletions in progressive external ophthalmoplegia and Kearns-Sayre syndrome. N Engl J Med 320:1293–1299
Morgan-Hughes JA, Landon DN (1984) Mitochondrial respiratory chain deficiencies in man. Some histochemical and fine-structural observations. In: Serratrice G, et al (eds) Neuromuscular diseases. Raven Press, New York, pp. 23–37
Morgan-Hughes JA, Hayes DJ, Clark JB et al (1982) Mitochondrial encephalopathies. Biochemical studies in two cases revealing defects in the respiratory chain. Brain 105:553–582
Partin JC, Schubert WK, Partin JS (1971) Mitochondrial ultrastructure in Reye's syndrome (encephalopathy and fatty degeneration of the viscera). N Engl J Med 285:1339–1343
Patten BM, Shabot JM, Alperin J, Dodson RF (1977) Hepatitis-associated lipid storage myopathy. Ann Intern Med 87:417–421
Rosenhall U, Johansson G, Orndahl G (1987) (a) Eye motility dysfunction in chronic primary fibromyalgia with dysesthesia. Scand J Rehab Med 19:139–145
Rosenhall U, Johannson G, Orndahl G (1987) (b) Neuroaudiological findings in chronic primary fibromyalgia with dysesthesia. Scan J Rehab Med 19:147–152
Rowland LP (1983) Molecular genetics, pseudogenetics and clinical neurology. Neurolygy 33:1179–1195
Veerkamp JH (1981) The function of muscle mitochondria. In: Busch, HFM, Jennekens F, Scholte HR (eds) Mitochondria and muscle disease. Mefar bv, Beetsterzwaag, The Netherlands, pp 29–50
Author information
Authors and Affiliations
Additional information
Supported by the Barclay Research Trust
Rights and permissions
About this article
Cite this article
Behan, W.M.H., More, I.A.R. & Behan, P.O. Mitochondrial abnormalities in the postviral fatigue syndrome. Acta Neuropathol 83, 61–65 (1991). https://doi.org/10.1007/BF00294431
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00294431