E2 ModeratePreliminaryPEM not requiredCross-SectionalPeer-reviewedReviewed
Standard · 3 min
Rhinitis symptoms in chronic fatigue syndrome.
Baraniuk, J N, Clauw, D J, Gaumond, E · Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 1998 · DOI
Quick Summary
This study looked at whether people with ME/CFS have more nasal and sinus problems than the general population. Researchers compared 51 ME/CFS patients with healthy controls and people with allergies, using questionnaires and allergy skin tests. They found that most ME/CFS patients reported significant nasal and sinus symptoms, but about half of these cases appeared to be non-allergic in nature.
Why It Matters
This study highlights that nasal and sinus symptoms are common in ME/CFS but may have different underlying causes than typical allergies. Understanding whether these symptoms are allergic or nonallergic could help develop better treatments and provides clues about what mechanisms drive ME/CFS symptoms.
Observed Findings
83% of skin test-positive CFS patients reported significant rhinitis complaints compared to only 23% of healthy controls
76% of skin test-negative CFS patients also reported significant rhinitis complaints, nearly equal to allergic groups
Systemic Complaints scores were elevated in 94% of both CFS groups regardless of skin test results
Allergy skin test positivity was similar between CFS (35%) and healthy controls (44%), suggesting allergic sensitization alone does not explain rhinitis prevalence in CFS
46% of the CFS population appeared to have nonallergic rhinitis based on symptom patterns without positive skin tests
Inferred Conclusions
Rhinitis symptoms are highly prevalent in ME/CFS but often occur independently of allergic sensitization
A significant subset of CFS patients (approximately 46%) may have nonallergic rhinitis, suggesting distinct pathophysiologic mechanisms beyond classical allergy
The widespread systemic complaints in CFS patients distinguish them from allergic rhinitis patients, implying shared multisystem pathophysiology
Nonallergic rhinitis mechanisms in CFS warrant further investigation as they may offer insights into CFS pathogenesis
Remaining Questions
What This Study Does Not Prove
This study does not prove that rhinitis causes ME/CFS or vice versa—it only shows they frequently occur together. The cross-sectional design cannot establish temporal relationships or causality. The findings may not generalize to all ME/CFS populations, as this was a single-center study with a relatively modest sample size.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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