Deumer, Undine-Sophie, Varesi, Angelica, Floris, Valentina et al. · Journal of clinical medicine · 2021 · DOI
ME/CFS is a long-term illness that causes extreme tiredness, worsening of symptoms after activity, and difficulty thinking clearly. Patients experience these symptoms very differently from one another, and currently there are no blood tests or physical exams that can definitively diagnose the condition. This review examines several potential causes, including past infections, genetic factors, hormone imbalances, and changes in gut bacteria, while exploring whether a simple blood test might someday help diagnose ME/CFS.
This comprehensive review addresses a critical gap in ME/CFS medicine: the absence of diagnostic biomarkers and molecular consensus despite decades of research. By synthesizing multi-disciplinary evidence on potential disease mechanisms and highlighting non-coding RNA as a diagnostic tool, the review provides a roadmap for future research that could lead to objective diagnostic tests and better treatment strategies for patients currently diagnosed only by symptoms.
As a narrative review, this study does not establish causation for any proposed mechanism—it synthesizes existing correlational data. The heterogeneity acknowledged by the authors means no single mechanism proposed here likely explains all ME/CFS cases. The review does not provide new experimental evidence or validate any specific biomarker for clinical use.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Deumer, Undine-Sophie, Varesi, Angelica, Floris, Valentina, Savioli, Gabriele, Mantovani, Elisa, López-Carrasco, Paulina, et al. (2021). Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): An Overview.. Journal of clinical medicine. https://doi.org/10.3390/jcm10204786
BibTeX
@article{mecfsatlas-deumer-2021-myalgic-encephalomyelitis,
author = {Deumer, Undine-Sophie and Varesi, Angelica and Floris, Valentina and Savioli, Gabriele and Mantovani, Elisa and López-Carrasco, Paulina and Rosati, Gian Marco and Prasad, Sakshi and Ricevuti, Giovanni},
title = {Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): An Overview.},
journal = {Journal of clinical medicine},
year = {2021},
doi = {10.3390/jcm10204786},
note = {PubMed: 34682909},
url = {https://www.mecfsatlas.com/evidence/deumer-2021-myalgic-encephalomyelitis},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/deumer-2021-myalgic-encephalomyelitis
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