Komaroff, A L · Ciba Foundation symposium · 1993 · DOI
ME/CFS is a long-lasting illness that causes severe tiredness lasting at least six months, along with other symptoms like fever, sore throat, joint pain, and worsening after physical activity. While some symptoms can look like mental health conditions, ME/CFS has physical features—like sudden onset following a flu-like illness and post-exertional exhaustion—that suggest it involves real biological problems. This condition significantly impacts people's ability to work, study, and care for themselves.
This foundational review helped establish ME/CFS as a legitimate clinical entity with identifiable symptom patterns and disease mechanisms distinct from psychiatric illness. For patients, it validates that their experience represents an organic medical condition; for researchers, it provided an important early framework for understanding disease presentation and differential diagnosis.
This review does not establish the underlying biological cause or mechanism of ME/CFS, nor does it prove causation between any specific infectious trigger and development of the syndrome. It also cannot definitively distinguish ME/CFS from other conditions with overlapping symptoms without application of specific diagnostic criteria, and as a 1993 review, it predates modern biomarker research.
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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