Leone, Ariane, Gerrer, Katrin, Viereck, Anja et al. · Frontiers in pediatrics · 2026 · DOI
This study examined whether adolescents with ME/CFS have postural orthostatic tachycardia syndrome (PoTS), a condition where heart rate rises abnormally when standing up. Researchers compared 18 young people with ME/CFS to 18 healthy controls using interviews and a 10-minute standing test. PoTS was observed in 7 of the 18 ME/CFS patients but in none of the healthy controls. The study reports that a combination of symptom history and heart rate patterns during standing may help doctors diagnose PoTS in young people with ME/CFS, though the authors note further research is needed to confirm whether these findings apply more broadly.
Orthostatic intolerance and PoTS are commonly reported by ME/CFS patients and may contribute to disability. This case–control study provides preliminary evidence that PoTS is associated with ME/CFS in adolescents at substantially higher prevalence than in healthy peers. Clarifying diagnostic thresholds for PoTS in young people with ME/CFS may improve clinical recognition and enable more rigorous phenotyping in future research.
This study does not establish that PoTS causes ME/CFS or vice versa; association alone cannot infer direction or mechanism. The small sample (18 per group) and unknown peer-review status mean findings may not generalise to other adolescent ME/CFS populations or age groups. The study does not compare different diagnostic criteria head-to-head in a sufficiently powered design to validate the proposed ≥60% threshold definitively.
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
Leone, Ariane, Gerrer, Katrin, Viereck, Anja, Grabbe, Annika, Kircher, Alissa, Behrends, Uta, et al. (2026). Postural orthostatic tachycardia syndrome in adolescents with ME/CFS - a case control study.. Frontiers in pediatrics. https://doi.org/10.3389/fped.2026.1836407
BibTeX
@article{mecfsatlas-leone-2026-postural-orthostatic,
author = {Leone, Ariane and Gerrer, Katrin and Viereck, Anja and Grabbe, Annika and Kircher, Alissa and Behrends, Uta and Maier, Andrea},
title = {Postural orthostatic tachycardia syndrome in adolescents with ME/CFS - a case control study.},
journal = {Frontiers in pediatrics},
year = {2026},
doi = {10.3389/fped.2026.1836407},
note = {PubMed: 42746015},
url = {https://www.mecfsatlas.com/evidence/leone-2026-postural-orthostatic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-09-18. https://www.mecfsatlas.com/evidence/leone-2026-postural-orthostatic
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