Varied presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and the needs for classification and clinician education: a case series, by Eva Martín-Martínez, & Mercedes Martín-Martínez in Clinical Therapeutics vol 41, issue 4, pages 619–624, April 2019


Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, heterogeneous and serious disease.

In this article, we analyze the cases of 3 patients with ME/CFS. Due to the disbeliefs, misconceptions, and stigmas that are attached to ME/CFS, patient diagnosis is made after years of disease progression. Over this period, physicians tried to determine the etiology of the disease, taking into account its onset and symptoms.

The suspected conditions correlated with possible subgroups that researchers speculate may exist in ME/CFS. Therefore, a registry of well-selected data on clinical history could help to cluster patients into more homogenous groups, and could be beneficial for research


The three cases reported highlight the need of a better medical training to get early diagnosis and a better management of the disease, and in this way it will be also possible to get samples in the early stages of the pathology.

Interestingly, in these clinical cases, the onset correlate with several of the different approaches researches followed: immune, inflammatory, genetic or metabolic disease. Therefore, clinicians can contribute to the generation of subgroups of ME/SCF patients based on clinical presentation and the occurrence of comorbidities.

To this aim, a complete clinical history should be obtained and a minimum of variables should be registered: triggers, onset, localized or generalized affectation, existence of family history, degree of disability, and comorbidities.

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