E2 ModeratePreliminaryPEM not requiredCross-SectionalPeer-reviewedReviewed
Ureaplasma urealyticum and Mycoplasma hominis in women with systemic lupus erythematosus.
Ginsburg, K S, Kundsin, R B, Walter, C W et al. · Arthritis and rheumatism · 1992 · DOI
Quick Summary
This study looked for a type of bacteria called mycoplasma in urine samples from women with two different conditions: systemic lupus erythematosus (SLE, an autoimmune disease) and ME/CFS (chronic fatigue syndrome). They found that mycoplasma was much more common in the SLE group (63%) than in the ME/CFS group (4.5%), suggesting these conditions may have different underlying causes.
Why It Matters
This study is relevant to ME/CFS research because it suggests that mycoplasma infection patterns differ substantially between ME/CFS and other systemic conditions like SLE. Understanding whether mycoplasma plays a role in ME/CFS pathogenesis could inform investigation of infectious triggers or microbial contributions to disease mechanisms.
Observed Findings
- 63% of SLE patients were culture-positive for mycoplasma, compared to 4.5% of CFS patients
- The difference between groups was statistically significant (P<0.001)
- Corticosteroid treatment did not account for the difference in mycoplasma prevalence
- SLE disease activity levels did not account for the difference between groups
- Patient age did not account for the difference between groups
Inferred Conclusions
- Genitourinary mycoplasma colonization occurs significantly more frequently in SLE than in CFS
- Mycoplasma prevalence differences between SLE and CFS are not explained by corticosteroid use, disease activity, or age
- The pathogenic mechanisms underlying SLE and CFS may differ with respect to mycoplasma involvement
Remaining Questions
- Does mycoplasma colonization have a causal role in either SLE or ME/CFS, or is it an incidental finding?
- Do mycoplasma-positive ME/CFS patients represent a distinct subgroup with different clinical features or outcomes?
- Why is mycoplasma colonization so much more common in SLE—is this related to immune dysregulation specific to SLE?
What This Study Does Not Prove
This study does not establish that mycoplasma causes either SLE or ME/CFS, only that colonization rates differ between groups. The cross-sectional design cannot determine whether mycoplasma colonization precedes symptom onset or results from disease-related immune dysfunction. The small CFS sample size (n=22) limits generalizability to the broader ME/CFS population.
Tags
Symptom:Fatigue
Method Flag:Weak Case DefinitionSmall SampleExploratory Only
Biomarker:Autoantibodies
Phenotype:Infection-Triggered
Metadata
- DOI
- 10.1002/art.1780350412
- PMID
- 1567492
- Review status
- Editor reviewed
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 12 April 2026
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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