Kanayama, Y · Nihon rinsho. Japanese journal of clinical medicine · 1992
This review article describes the main symptoms and characteristics of ME/CFS, including persistent fatigue lasting more than 6 months, low-grade fevers, swollen lymph nodes, muscle and joint pain, and mood-related symptoms. Since no specific blood test or scan can definitively diagnose ME/CFS, doctors must rule out other known causes of fatigue before making the diagnosis. The underlying cause remains unknown, though researchers suspect it may involve an infection combined with psychological factors.
This early clinical review helped establish and standardize how ME/CFS was recognized and described in medical practice, laying groundwork for more rigorous diagnostic criteria. Understanding the historical consensus on core symptoms remains relevant for validating patient experiences and informing current research directions aimed at uncovering objective biomarkers.
This review does not establish specific causes of ME/CFS or prove any infectious agent's involvement—it only notes suspicion based on symptom patterns. It cannot define the precise pathophysiology or distinguish definitively between physical and psychological contributions to the condition. The narrative format means conclusions reflect authors' interpretation rather than systematic analysis of controlled evidence.
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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