Natelson, B H, LaManca, J J, Denny, T N et al. · The American journal of medicine · 1998 · DOI
Researchers compared blood immune system markers between ME/CFS patients, people with depression, people with multiple sclerosis, and healthy controls. They measured 18 different immune system measurements, looking for signs that ME/CFS involves immune system problems. The study found only minor differences in one immune protein between ME/CFS patients and healthy controls, and these differences disappeared when comparing across all three disease groups.
This study directly tested a major hypothesis in ME/CFS—that the illness involves detectable immune system dysfunction—using objective laboratory measures. The inclusion of disease comparison groups (MS and depression) strengthens the argument that any immune abnormalities found are specific to ME/CFS rather than general consequences of chronic illness or fatigue.
This study does not prove that ME/CFS has no immune component; it only found no differences in these specific 18 markers measured in blood. Cross-sectional design prevents conclusions about causation or disease progression, and the study cannot rule out immune dysfunction in tissues, at the cellular level, or in immune functions not measured here. The lack of significant findings may reflect limitations in which immune parameters were selected rather than absence of immune involvement.
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
Natelson, B H, LaManca, J J, Denny, T N, Vladutiu, A, Oleske, J, Hill, N, et al. (1998). Immunologic parameters in chronic fatigue syndrome, major depression, and multiple sclerosis.. The American journal of medicine. https://doi.org/10.1016/s0002-9343(98)00165-x
BibTeX
@article{mecfsatlas-natelson-1998-immunologic-parameters,
author = {Natelson, B H and LaManca, J J and Denny, T N and Vladutiu, A and Oleske, J and Hill, N and Bergen, M T and Korn, L and Hay, J},
title = {Immunologic parameters in chronic fatigue syndrome, major depression, and multiple sclerosis.},
journal = {The American journal of medicine},
year = {1998},
doi = {10.1016/s0002-9343(98)00165-x},
note = {PubMed: 9790481},
url = {https://www.mecfsatlas.com/evidence/natelson-1998-immunologic-parameters},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/natelson-1998-immunologic-parameters
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