Nickel Allergy Is Found in a Majority of Women with Chronic Fatigue Syndrome and Muscle Pain– And May Be Triggered by Cigarette Smoke and Dietary Nickel Intake

Two hundred and four women with chronic fatigue and muscle pain, with no signs of autoimmune disorder, received immune stimulation injections with a Staphylococcus vaccine at monthly intervals over 6 months. Good response was defined as a decrease by at least 50% of the total score on an observer’s rating scale. Nickel allergy was evaluated as probable if the patient had a positive history of skin hypersensitivity from cutaneous exposure to metal objects. The patient’s smoking habits were recorded. Fifty-two percent of the patients had a Björn Regland is Assistant Professor, Olof Zachrisson is Medical Doctor, and Carl-Gerhard Gottfries is Professor, all affiliated with the Department of Psychiatry, Sahlgrenska University Hospital/Mölndal and Institute of Clinical Neuroscience, Göteborg, Sweden. Vera Stejskal is Assistant Professor, Department of Clinical Chemistry, Danderyd Hospital and Karolinska Institute, Stockholm. Address correspondence to: Björn Regland, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, SE-431 80 Mölndal, Sweden (E-mail: bjorn.regland @ms.se). The authors express their thanks to Swiss Serum & Vaccine Institute Berne for providing them with the Staphylococcus vaccine, and to Veronica Nordman for the performance of in vitro testing. Journal of Chronic Fatigue Syndrome, Vol. 8(1) 2001 2001 by The Haworth Press, Inc. All rights reserved. 57 JOURNAL OF CHRONIC FATIGUE SYNDROME 58 positive history of nickel contact dermatitis. There were significantly more good responders among the non-allergic non-smokers (39%) than among the allergic smokers (6%). We also present case reports on nickel-allergic patients who apparently improved after cessation of cigarette smoking and reducing their dietary nickel intake. Our observations indicate that exposure to nickel, by dietary intake or inhalation of cigarette smoke, may trigger systemic nickel allergy and contribute to syndromes of chronic fatigue and muscle pain. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: 2001 by The Haworth Press, Inc. All rights reserved.]