Levine, P H, Dale, J K, Benson-Grigg, E et al. · Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 1996 · DOI
This study examined a group of people who developed chronic fatigue syndrome (ME/CFS), looking at their medical histories and immune system patterns to understand what might have caused their illness. Researchers compared patients with ME/CFS to control groups and measured various immune markers in their blood. The goal was to identify common features that might explain why these individuals became ill.
This study was one of the early systematic attempts to examine immune dysfunction in ME/CFS patients and to investigate whether cases cluster geographically or epidemiologically, which could suggest infectious or environmental triggers. Understanding whether ME/CFS presents with consistent immunologic patterns helps establish the biological basis of the disease and supports the need for objective diagnostic markers.
This study does not prove that a specific pathogen or environmental factor caused ME/CFS, only that immune abnormalities exist in affected individuals. The case-control design cannot establish causation, and the findings represent correlation only. Without follow-up mechanistic studies, the clinical significance of the identified immune changes remains unclear.
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
Levine, P H, Dale, J K, Benson-Grigg, E, Fritz, S, Grufferman, S, & Straus, S E (1996). A cluster of cases of chronic fatigue and chronic fatigue syndrome: clinical and immunologic studies.. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. https://doi.org/10.1093/clinids/23.2.408
BibTeX
@article{mecfsatlas-levine-1996-cluster-cases,
author = {Levine, P H and Dale, J K and Benson-Grigg, E and Fritz, S and Grufferman, S and Straus, S E},
title = {A cluster of cases of chronic fatigue and chronic fatigue syndrome: clinical and immunologic studies.},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {1996},
doi = {10.1093/clinids/23.2.408},
note = {PubMed: 8842294},
url = {https://www.mecfsatlas.com/evidence/levine-1996-cluster-cases},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/levine-1996-cluster-cases
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