Martín-Martínez, Eva, Martín-Martínez, Mercedes · Clinical therapeutics · 2019 · DOI
This study looked at three individual ME/CFS patient cases to understand why this disease presents so differently from person to person. The researchers found that patients often wait years for a correct diagnosis because many doctors don't understand ME/CFS well, leading to misdiagnosis and delays in treatment. The study suggests that organizing patient information carefully could help doctors and researchers identify different subtypes of ME/CFS.
This work highlights a critical problem affecting many ME/CFS patients—delayed diagnosis due to clinician unfamiliarity and stigma—which prolongs suffering and prevents timely management. By demonstrating the clinical heterogeneity of ME/CFS through real patient examples, the study underscores why better classification systems and clinician education are essential for improving diagnostic accuracy and patient outcomes. The proposed registry approach could help researchers understand ME/CFS subtypes, potentially leading to more targeted treatments.
This case series does not establish the prevalence of different ME/CFS presentations or prove that proposed subgroups actually exist biologically. It does not demonstrate that a registry system would successfully improve outcomes, nor does it provide quantitative data about diagnosis delays across broader populations. The study is observational and cannot establish causal relationships between clinical features and disease mechanisms.
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 →
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Primary citation
Martín-Martínez, Eva & Martín-Martínez, Mercedes (2019). Varied Presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and the Needs for Classification and Clinician Education: A Case Series.. Clinical therapeutics. https://doi.org/10.1016/j.clinthera.2019.02.014
BibTeX
@article{mecfsatlas-martn-martnez-2019-varied-presentation,
author = {Martín-Martínez, Eva and Martín-Martínez, Mercedes},
title = {Varied Presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and the Needs for Classification and Clinician Education: A Case Series.},
journal = {Clinical therapeutics},
year = {2019},
doi = {10.1016/j.clinthera.2019.02.014},
note = {PubMed: 30948154},
url = {https://www.mecfsatlas.com/evidence/martn-martnez-2019-varied-presentation},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/martn-martnez-2019-varied-presentation
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