A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour

Keijmel, Stephan P.; Saxe, J C; Meer, J.W.M. van der; Nikolaus, Stephanie; Netea, Mihai G.; Bleijenberg, Gijs; Bleeker‐Rovers, Chantal P.; Knoop, Hans

doi:10.1016/j.jpsychores.2015.07.005

Cited by 31 publications

(28 citation statements)

References 41 publications

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“…A change in beliefs about fatigue and the ability to become active seems to mediate the positive effects in CBT for CFS [31]. Previously, an overlap in fatigue-related and cognitive-behavioral variables between QFS and CFS was found, but the relationship between perpetuating factors and fatigue as is found in CFS could not be confirmed in QFS [12]. Although CBT proved effective in reducing fatigue and psychological distress in QFS patients as well, it remains unclear whether the process of change during CBT in QFS is similar to that in CFS [31].…”

Section: Discussionmentioning

confidence: 88%

“…This Q fever fatigue syndrome (QFS) persists for years in approximately 20% of cases following acute Q fever [2][3][4][5][6][9][10][11]. Many QFS patients fulfill the case definition of chronic fatigue syndrome (CFS) [2,8,10,12]. QFS has major health impacts with severe fatigue, substantial disabilities, and reduced quality of life [8,11,[13][14][15].…”

mentioning

confidence: 99%

“…Cognitive-behavioral therapy (CBT), aimed at fatigue-related cognitions and behavior thought to perpetuate symptoms, can reduce symptoms and improve functioning in CFS [19]. A considerable overlap in fatigue-perpetuating factors between QFS and CFS implies that CBT might also reduce fatigue severity in QFS [12].…”

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confidence: 99%

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Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Keijmel

Delsing

Bleijenberg

et al. 2017

Clinical Infectious Diseases

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Background. Approximately 20% of patients with acute Q fever will develop chronic fatigue, referred to as Q fever fatigue syndrome (QFS). The objective of this randomized controlled clinical trial was to assess the efficacy of either long-term treatment with doxycycline or cognitive-behavioral therapy (CBT) in reducing fatigue severity in patients with QFS.Methods. Adult patients were included who met the QFS criteria according to the Dutch guideline: a new onset of severe fatigue lasting ≥6 months with significant disabilities, related to an acute Q fever infection, without other somatic or psychiatric comorbidity explaining the fatigue. Using block randomization, patients were randomized between oral study medication and CBT (2:1) for 24 weeks. Second, a double-blind randomization between doxycycline (200 mg/day, once daily) and placebo was performed in the medication group. Primary outcome was fatigue severity at end of treatment (EOT; week 26), assessed with the Checklist Individual Strength subscale Fatigue Severity.Results. Of 155 patients randomized, 154 were included in the intention-to-treat analysis (doxycycline, 52; placebo, 52; CBT, 50). At EOT, fatigue severity was similar between doxycycline (40.8 [95% confidence interval {CI}, 37.3-44.3]) and placebo (37.8 [95% CI,.2]; difference, doxycycline vs placebo, −3.0 [97.5% CI, −8.7 to 2.6]; P = .45). Fatigue severity was significantly lower after CBT (31.6 [95% CI,.1]) than after placebo (difference, CBT vs placebo, 6.2 [97.5% CI, .5-11.9]; P = .03).Conclusions. CBT is effective in reducing fatigue severity in QFS patients. Long-term treatment with doxycycline does not reduce fatigue severity in QFS patients compared to placebo.Clinical Trials Registration. NCT01318356.

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Section: Discussionmentioning

confidence: 88%

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confidence: 99%

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Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Keijmel

Delsing

Bleijenberg

et al. 2017

Clinical Infectious Diseases

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“…QFS was rst described by Shannon et al in 1993 and occurs worldwide (2,3). In many ways, complaints of QFS are similar to those of chronic fatigue syndrome (CFS) (4,5), and the pathogenesis of these syndromes remains largely unclear. An important distinction between QFS and CFS is the fact that QFS has a known aetiology, being precipitated by an acute Q fever infection, and is therefore considered to be a postinfectious fatigue syndrome.…”

Section: Discussionmentioning

confidence: 99%

Multi-omics Examination of Q Fever Fatigue Syndrome Identifies Similarities with Chronic Fatigue Syndrome

Raijmakers

Roerink

Jansen

et al. 2020

Preprint

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Background: Q fever fatigue syndrome (QFS) is characterised by a state of prolonged fatigue that is seen in 20% of acute Q fever infections and has major health-related consequences. The molecular mechanisms underlying QFS are largely unclear. In order to better understand its pathogenesis, we applied a multi-omics approach to study the patterns of the gut microbiome, blood metabolome, and inflammatory proteome of QFS patients, and compared these with those of chronic fatigue syndrome (CFS) patients and healthy controls (HC). Methods: The study population consisted of 31 QFS patients, 50 CFS patients, and 72 HC. All subjects were matched for age, gender, and general geographical region (South-East part of the Netherlands). The gut microbiome composition was assessed by Metagenomic sequencing using the Illumina HiSeq platform. A total of 92 circulating inflammatory markers were measured using Proximity Extension Essay and 1607 metabolic features were assessed with a high-throughput non-targeted metabolomics approach. Results: Inflammatory markers, including 4E-BP1 (P = 9.60-16 and 1.41-7) and MMP-1 (P = 7.09-9 and 3.51-9), are significantly more expressed in both QFS and CFS patients compared to HC, and QFS patients show more of an inflammatory profile than CFS patients and HC. Blood metabolite profiles show significant differences when comparing QFS (319 metabolites) and CFS (441 metabolites) patients to HC, and are significantly enriched in pathways like sphingolipid (P = 0.0256 and 0.0033) metabolism. When comparing QFS to CFS patients, almost no significant differences in metabolome were found. Comparison of microbiome taxonomy of QFS and CFS patients with that of HC, shows both in- and decreases in abundancies in Bacteroidetes (with emphasis on Bacteroides and Alistiples spp.), and Firmicutes and Actinobateria (with emphasis on Ruminococcus and Bifidobacterium spp.). When we compare QFS patients to CFS patients, there is a striking resemblance and hardly any significant differences in microbiome taxonomy are found. Conclusions: We show that QFS and CFS patients are similar across three different omics layers and 4E-BP1 and MMP-1 have the potential to distinguish QFS and CFS patients from HC.

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“…Recently, another study from The Netherlands on 'Q fever fatigue syndrome' used the definition of the National Dutch consensus guidelines, which is cited as follows: 'a sudden onset of fatigue related to a symptomatic acute Q fever infection' [15]. Given the data from Van Loenhout et al [1], this definition is obviously misleading.…”

Section: Moving From Q Fever To C Burnetii Infectionmentioning

confidence: 99%

Moving from Q fever to C. burnetii infection

Eldin

Raoult

2015

Epidemiol. Infect.

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A comparison of patients with Q fever fatigue syndrome and patients with chronic fatigue syndrome with a focus on inflammatory markers and possible fatigue perpetuating cognitions and behaviour

Cited by 31 publications

References 41 publications

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Effectiveness of Long-term Doxycycline Treatment and Cognitive-Behavioral Therapy on Fatigue Severity in Patients with Q Fever Fatigue Syndrome (Qure Study): A Randomized Controlled Trial

Multi-omics Examination of Q Fever Fatigue Syndrome Identifies Similarities with Chronic Fatigue Syndrome

Moving from Q fever to C. burnetii infection

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