Bell, D S · Postgraduate medicine · 1992 · DOI
ME/CFS typically starts suddenly with severe tiredness and flu-like symptoms that come and go over months or years. While blood tests sometimes show immune system changes, doctors diagnose ME/CFS mainly by recognizing the pattern of symptoms and ruling out other illnesses. Current treatment focuses on managing symptoms and helping patients cope with this long-lasting, disabling condition.
This work provides clinicians with practical diagnostic guidance for ME/CFS and acknowledges that currently available biomarkers cannot definitively confirm disease, validating patients' experiences of a real illness despite normal physical examinations. It highlights the need for better diagnostic tools and underscores that symptom management and psychosocial support remain core therapeutic approaches.
This review does not establish the underlying biological cause of ME/CFS or explain why immunological abnormalities occur. It does not prove that symptomatic treatment is curative or optimal, only that it represents current practice. It cannot determine whether immunological changes are causative, consequential, or merely associated with disease.
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 →
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