Morrison, R E, Keating, H J · Obstetrics and gynecology clinics of North America · 2001 · DOI
Fatigue is very common and can have many different causes. Doctors can usually figure out what's causing someone's tiredness through a careful conversation, physical exam, and a few blood tests. In rare cases, people have extreme fatigue lasting 6 months or longer that doesn't have an obvious cause—this may be chronic fatigue syndrome (ME/CFS).
This work is relevant to ME/CFS patients because it acknowledges chronic fatigue syndrome as a distinct diagnostic entity that emerges after thorough exclusion of other causes. It underscores the importance of systematic clinical evaluation and validates the need for careful differential diagnosis, which is fundamental to accurate ME/CFS identification in primary care.
This review does not establish the prevalence, etiology, or pathophysiology of ME/CFS itself. It does not provide evidence about specific diagnostic criteria, biomarkers, or treatment efficacy for ME/CFS. It also does not clarify how physicians should definitively diagnose ME/CFS or distinguish it from other fatigue-causing conditions when overlap exists.
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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