Itoh, Y, Igarashi, T, Tatsuma, N et al. · Nihon Ika Daigaku zasshi · 1999 · DOI
This study looked at two patients who were initially thought to have autoimmune fatigue syndrome (a condition where the immune system may attack the body and cause tiredness) but were later found to have fibromyalgia (widespread muscle pain and tender points). The researchers wondered if these two conditions might be related, so they checked how many tender points fibromyalgia patients had and looked at their immune markers. They found that patients with certain immune patterns had more tender points, suggesting autoimmunity might play a role in both conditions.
This study proposes that autoimmunity may explain why fibromyalgia and ME/CFS (chronic fatigue syndrome) have historically been controversial or misunderstood diagnoses. If autoimmune mechanisms underlie both conditions, it could support a biological basis for these illnesses and guide more targeted diagnostic and treatment approaches.
This small case study does not prove that all fibromyalgia or ME/CFS cases are autoimmune, nor does it establish causation—only an association between immune markers and tender point distribution. The findings cannot be generalized to larger patient populations without larger, prospective studies. The cross-sectional design cannot determine whether autoimmune activation precedes or results from the pain syndrome.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Itoh, Y, Igarashi, T, Tatsuma, N, Imai, T, Yoshida, J, Tsuchiya, M, et al. (1999). [Autoimmune fatigue syndrome and fibromyalgia syndrome].. Nihon Ika Daigaku zasshi. https://doi.org/10.1272/jnms.66.239
BibTeX
@article{mecfsatlas-itoh-1999-autoimmune-fatigue,
author = {Itoh, Y and Igarashi, T and Tatsuma, N and Imai, T and Yoshida, J and Tsuchiya, M and Murakami, M and Fukunaga, Y},
title = {[Autoimmune fatigue syndrome and fibromyalgia syndrome].},
journal = {Nihon Ika Daigaku zasshi},
year = {1999},
doi = {10.1272/jnms.66.239},
note = {PubMed: 10466339},
url = {https://www.mecfsatlas.com/evidence/itoh-1999-autoimmune-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/itoh-1999-autoimmune-fatigue
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