Krumina, Angelika, Vecvagare, Katrine, Svirskis, Simons et al. · Medicina (Kaunas, Lithuania) · 2021 · DOI
This study looked at 65 people with ME/CFS in Latvia to understand their main symptoms and how the condition differs from simple tiredness. Researchers found that people with ME/CFS commonly experience fatigue, muscle pain, joint pain, and sleep problems—more often than people without ME/CFS. When patients had other health conditions alongside ME/CFS, their symptoms tended to be more severe.
Diagnostic clarity and understanding symptom severity patterns are critical for ME/CFS patients seeking recognition and appropriate care. This study contributes real-world clinical data on how ME/CFS presents differently from other fatigue-related conditions and identifies that comorbidities significantly worsen outcomes—information valuable for both patient education and clinician training.
This study does not establish causation or why comorbidities worsen ME/CFS severity. The small, single-center sample from Latvia may not represent ME/CFS populations in other regions or ethnic groups. The finding that NSAIDs are commonly used does not prove they are an evidence-based treatment, only that patients report using them.
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
Krumina, Angelika, Vecvagare, Katrine, Svirskis, Simons, Gravelsina, Sabine, Nora-Krukle, Zaiga, Gintere, Sandra, et al. (2021). Clinical Profile and Aspects of Differential Diagnosis in Patients with ME/CFS from Latvia.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina57090958
BibTeX
@article{mecfsatlas-krumina-2021-clinical-profile,
author = {Krumina, Angelika and Vecvagare, Katrine and Svirskis, Simons and Gravelsina, Sabine and Nora-Krukle, Zaiga and Gintere, Sandra and Murovska, Modra},
title = {Clinical Profile and Aspects of Differential Diagnosis in Patients with ME/CFS from Latvia.},
journal = {Medicina (Kaunas, Lithuania)},
year = {2021},
doi = {10.3390/medicina57090958},
note = {PubMed: 34577881},
url = {https://www.mecfsatlas.com/evidence/krumina-2021-clinical-profile},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/krumina-2021-clinical-profile
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