Itoh, Y, Imai, T, Fujino, O et al. · Modern rheumatology · 2002 · DOI
This study looked at children with severe fatigue and found that some had a specific antibody (anti-Ro/SSA) in their blood that is also found in Sjögren's syndrome, an autoimmune condition affecting moisture-producing glands. Eight children with fatigue syndrome tested positive for this antibody, and two of them showed actual gland damage on biopsy similar to Sjögren's syndrome, suggesting that some fatigue cases may actually be caused by an autoimmune condition affecting the glands.
This research is relevant to ME/CFS because it identifies an autoimmune subset of patients with chronic fatigue who may have specific immunological markers (anti-Ro/SSA) and underlying glandular pathology. Understanding whether ME/CFS patients might similarly harbor undiagnosed autoimmune conditions could open new diagnostic and therapeutic avenues, particularly in pediatric populations.
This study does not establish that anti-Ro/SSA positivity causes fatigue, nor does it prove that all autoimmune fatigue syndrome cases are Sjögren's syndrome. The cross-sectional design cannot establish temporal relationships or causality. The study cannot determine whether anti-Ro/SSA is present in typical ME/CFS populations or whether similar mechanisms operate in adult ME/CFS.
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, Imai, T, Fujino, O, Igarashi, T, & Fukunaga, Y (2002). Subclinical Sjögren's syndrome and anti-Ro/SSA-positive autoimmune fatigue syndrome in children.. Modern rheumatology. https://doi.org/10.3109/s101650200035
BibTeX
@article{mecfsatlas-itoh-2002-subclinical-gren,
author = {Itoh, Y and Imai, T and Fujino, O and Igarashi, T and Fukunaga, Y},
title = {Subclinical Sjögren's syndrome and anti-Ro/SSA-positive autoimmune fatigue syndrome in children.},
journal = {Modern rheumatology},
year = {2002},
doi = {10.3109/s101650200035},
note = {PubMed: 24387058},
url = {https://www.mecfsatlas.com/evidence/itoh-2002-subclinical-gren},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/itoh-2002-subclinical-gren
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