Hashimoto, N, Kuraishi, Y, Yokose, T et al. · Nihon rinsho. Japanese journal of clinical medicine · 1992
This study identified 51 patients with ME/CFS diagnosed using official CDC criteria between 1991 and 1992. Most patients were women in their 20s–30s who had been seen by many doctors before receiving a correct diagnosis. Standard blood tests did not reveal abnormal findings, though some immune markers were mildly abnormal. About 57% of patients showed general improvement, and doctors used various medications to manage severe symptoms.
This early study helped establish that ME/CFS is a recognizable clinical entity with consistent features and that standard medical workups often fail to identify it, validating the experiences of patients repeatedly told they have no medical condition. It also documents that some patients improve with supportive care, offering hope to newly diagnosed individuals.
This study does not prove the cause of ME/CFS, establish what specific immune abnormalities drive the disease, or determine which treatments are most effective—it only describes what doctors observed in clinical practice. The lack of a control group and reliance on case reports means observed associations (like infectious triggers or female predominance) may not reflect true disease mechanisms. The study cannot separate treatment effects from natural disease progression.
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
Hashimoto, N, Kuraishi, Y, Yokose, T, Tajima, N, Mochio, S, Shimizu, M, et al. (1992). [Chronic fatigue syndrome--51 cases in the Jikei University School of Medicine].. Nihon rinsho. Japanese journal of clinical medicine. https://pubmed.ncbi.nlm.nih.gov/1287241/
BibTeX
@article{mecfsatlas-hashimoto-1992-chronic-fatigue,
author = {Hashimoto, N and Kuraishi, Y and Yokose, T and Tajima, N and Mochio, S and Shimizu, M and Yokoyama, J and Kobayashi, N and Nohara, A and Taniguchi, I},
title = {[Chronic fatigue syndrome--51 cases in the Jikei University School of Medicine].},
journal = {Nihon rinsho. Japanese journal of clinical medicine},
year = {1992},
note = {PubMed: 1287241},
url = {https://www.mecfsatlas.com/evidence/hashimoto-1992-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/hashimoto-1992-chronic-fatigue
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