Kakumanu, Sujani S, Mende, Cathy N, Lehman, Erik B et al. · The Journal of the American Osteopathic Association · 2003
This study tested whether a nasal steroid spray could help people with ME/CFS who also have nasal inflammation and congestion. Twenty-eight patients received either the steroid spray or a placebo (fake spray) in different orders over 8 weeks. The spray did reduce daytime sleepiness, but it did not improve the core ME/CFS symptoms like fatigue, muscle pain, or problems with activity.
Many ME/CFS patients experience nasal congestion and sleep disruption. This study helps clarify whether treating rhinitis symptoms can improve ME/CFS fatigue, and suggests that the underlying cause of rhinitis in ME/CFS differs from typical allergic rhinitis, pointing toward distinct biological mechanisms that warrant further investigation.
This study does not establish that rhinitis plays no role in ME/CFS symptom severity; it only shows that treating nasal inflammation alone does not resolve core ME/CFS pathology. The findings apply only to patients with both conditions and cannot determine whether non-allergic rhinitis in ME/CFS arises from immune dysfunction, neurological factors, or other mechanisms. It also does not address whether treating rhinitis in patients without ME/CFS follows the same pattern.
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
Kakumanu, Sujani S, Mende, Cathy N, Lehman, Erik B, Hughes, Kathleen, & Craig, Timothy J (2003). Effect of topical nasal corticosteroids on patients with chronic fatigue syndrome and rhinitis.. The Journal of the American Osteopathic Association. https://pubmed.ncbi.nlm.nih.gov/14527077/
BibTeX
@article{mecfsatlas-kakumanu-2003-effect-topical,
author = {Kakumanu, Sujani S and Mende, Cathy N and Lehman, Erik B and Hughes, Kathleen and Craig, Timothy J},
title = {Effect of topical nasal corticosteroids on patients with chronic fatigue syndrome and rhinitis.},
journal = {The Journal of the American Osteopathic Association},
year = {2003},
note = {PubMed: 14527077},
url = {https://www.mecfsatlas.com/evidence/kakumanu-2003-effect-topical},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/kakumanu-2003-effect-topical
Contribute
Private, reviewed by a human. Not a public comment thread.