van de Putte, E M, Uiterwaal, C S P M, Bots, M L et al. · Pediatrics · 2005 · DOI
Researchers investigated whether ME/CFS is related to loose or stretchy connective tissue (the material that holds joints, skin, and blood vessels together). They compared 32 adolescents with ME/CFS to 167 healthy teenagers and measured joint flexibility, blood pressure, skin stretchiness, and blood vessel stiffness. While they found some differences—including lower blood pressure and stretchier skin in the ME/CFS group—they did not find the joint hypermobility that would be expected if ME/CFS were a connective tissue disorder.
This study directly addresses whether ME/CFS has a biological basis in connective tissue abnormalities—a question relevant to understanding disease mechanisms and potential treatments. It provides evidence against a simple connective tissue disorder model while identifying previously unreported vascular changes (arterial stiffness) that may warrant further investigation into cardiovascular dysfunction in ME/CFS.
This study does not prove that connective tissue abnormalities play no role in ME/CFS pathogenesis, only that constitutional laxity is not a primary feature in this adolescent cohort. The cross-sectional design cannot establish causation or determine whether vascular findings are primary or secondary to the disease. Results from adolescents may not generalize to adult ME/CFS populations.
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
van de Putte, E M, Uiterwaal, C S P M, Bots, M L, Kuis, W, Kimpen, J L L, & Engelbert, R H H (2005). Is chronic fatigue syndrome a connective tissue disorder? A cross-sectional study in adolescents.. Pediatrics. https://doi.org/10.1542/peds.2004-1515
BibTeX
@article{mecfsatlas-van-de-putte-2005-chronic-fatigue,
author = {van de Putte, E M and Uiterwaal, C S P M and Bots, M L and Kuis, W and Kimpen, J L L and Engelbert, R H H},
title = {Is chronic fatigue syndrome a connective tissue disorder? A cross-sectional study in adolescents.},
journal = {Pediatrics},
year = {2005},
doi = {10.1542/peds.2004-1515},
note = {PubMed: 15805343},
url = {https://www.mecfsatlas.com/evidence/van-de-putte-2005-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/van-de-putte-2005-chronic-fatigue
Contribute
Private, reviewed by a human. Not a public comment thread.