May, Margaret, Emond, Alan, Crawley, Esther · Archives of disease in childhood · 2010 · DOI
Researchers studied 333 children and young people with ME/CFS to see if the illness presents differently in different people. They found three main patterns: one involving muscle and joint pain, another involving migraine-like symptoms with sensitivity to light and sound, and a third involving sore throat and swollen lymph nodes. These different patterns were linked to varying levels of severity, suggesting that ME/CFS affects children in different ways.
This study demonstrates that ME/CFS in children is not a single uniform condition but comprises distinct symptom clusters that differ in severity and associated features. Recognizing these phenotypes could help clinicians tailor assessment and treatment strategies, and may ultimately guide targeted research into different biological mechanisms underlying ME/CFS.
This cross-sectional study cannot establish causation or determine whether these phenotypes represent truly distinct biological subtypes versus symptom clustering in a single disease. It does not prove that phenotypes remain stable over time, respond differently to treatment, or have different underlying mechanisms. The study also cannot establish why certain phenotypes associate with anxiety or whether these associations reflect causation.
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
May, Margaret, Emond, Alan, & Crawley, Esther (2010). Phenotypes of chronic fatigue syndrome in children and young people.. Archives of disease in childhood. https://doi.org/10.1136/adc.2009.158162
BibTeX
@article{mecfsatlas-may-2010-phenotypes-chronic,
author = {May, Margaret and Emond, Alan and Crawley, Esther},
title = {Phenotypes of chronic fatigue syndrome in children and young people.},
journal = {Archives of disease in childhood},
year = {2010},
doi = {10.1136/adc.2009.158162},
note = {PubMed: 19843509},
url = {https://www.mecfsatlas.com/evidence/may-2010-phenotypes-chronic},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/may-2010-phenotypes-chronic
Contribute
Private, reviewed by a human. Not a public comment thread.