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Chronic fatigue syndrome

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Disease classification WHO
G93.3 Postviral fatigue syndrome
not in classification

Chronic fatigue syndrome (CFS) is not a disease diagnosis, but a working case definition introduced to identify patients that may suffer from the underlying target disease.[1] While originally intended for scientific research only, it has become widely used in clinical practice as well. The diagnosis was introduced after an outbreak around Lake Tahoe, Nevada in the United States of America of what was initially thought to be a form of chronic mononucleosis. When this could not be confirmed, it got generally assumed that CFS primarily captures sufferers of myalgic encephalomyelitis, a post-viral neurological disease that had generated similar outbreaks all over the western world.[2] Since the beginning of the 21st century, there is a growing interest in identifying subgroups within the CFS patient population.[3]


CFS and ME are not synonyms, nor was CFS ever intended to replace the disease diagnosis ME.[4][5] Patients diagnosed with (only) CFS could be suffering from other illnesses, including post-polio syndrome, other post-viral fatigue syndromes or forms of fibromyalgia.[5] Patients with non-chronic ME do not qualify for a diagnosis of CFS. However, testing patients for CFS criteria could be considered the first step towards a diagnosis of ME (or other diseases).[4]


Associations Between Cognitive Performance and Pain in Chronic Fatigue Syndrome: Comorbidity with Fibromyalgia Does Matter


  1. Holmes G, Kaplan J, Gantz N, Komaroff A, Schonberger L, Straus S, Jones J, Dubois R, Cunningham-Rundles C, Pahwa S (1988), "Chronic fatigue syndrome: a working case definition", Annals of Internal Medicine, 108 (3), 387-389
  2. Carruthers BM, Jain AK, DeMeirleir KL, Peterson DL, Klimas NG, Lerner AM, Bested AC, Flor-Henry P, Joshi P, Powles ACP, Sherkey JA, Van de Sande MI (2003), "Myalgic Encephalomyelitis / Chronic Fatigue Syndrome : Clinical Working case Definition, Diagnostic and Treatment Protocols", Journal of Chronic Fatigue Syndrome, Vol. 11 (1)
  3. Tan EM, Sugiura K, Gupta S (2002), "The Case Definition of Chronic Fatigue Syndrome", J Clin Immunol, Vol. 22, No. 1, pp. 8-12
  4. 4.0 4.1 Den Broeder G (2008), "Testen op ME/CVS", Lees ME 5/6, ME/CVS Vereniging, Jul:37-41 + Dec:28-31 (Testing for ME/CFS)
  5. 5.0 5.1 Mackie Ph (2009), "Health Care Needs Assessment of Services for people living with ME-CFS" (draft for consultation), Scottish Public Health Network (ScotPHN), May, 20090517