Levine, P H, Whiteside, T L, Friberg, D et al. · Clinical immunology and immunopathology · 1998 · DOI
Researchers studied a family where 8 members had ME/CFS and found that their natural killer (NK) cells—immune cells that help fight infections and cancer—were not working as well as they should. Some unaffected family members also had lower NK activity, suggesting this might be an inherited trait. The findings raise the possibility that a genetic weakness in immune function could increase risk for both ME/CFS and cancer in this family.
This study provides early evidence that ME/CFS may involve a specific, measurable immune dysfunction (low NK activity) that could be inherited. Understanding genetic predisposition factors may eventually help identify at-risk individuals and could guide development of targeted immune therapies for ME/CFS.
This study does not prove that low NK activity causes ME/CFS—it only shows an association in this single family. The small sample size and familial clustering limit generalizability; findings may not apply to ME/CFS patients outside this family. The connection to pediatric malignancies is based on limited cases and requires much larger studies to establish statistical significance.
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, Whiteside, T L, Friberg, D, Bryant, J, Colclough, G, & Herberman, R B (1998). Dysfunction of natural killer activity in a family with chronic fatigue syndrome.. Clinical immunology and immunopathology. https://doi.org/10.1006/clin.1998.4554
BibTeX
@article{mecfsatlas-levine-1998-dysfunction-natural,
author = {Levine, P H and Whiteside, T L and Friberg, D and Bryant, J and Colclough, G and Herberman, R B},
title = {Dysfunction of natural killer activity in a family with chronic fatigue syndrome.},
journal = {Clinical immunology and immunopathology},
year = {1998},
doi = {10.1006/clin.1998.4554},
note = {PubMed: 9683556},
url = {https://www.mecfsatlas.com/evidence/levine-1998-dysfunction-natural},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/levine-1998-dysfunction-natural
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