Nunes, Jean M, Kruger, Arneaux, Proal, Amy et al. · Pharmaceuticals (Basel, Switzerland) · 2022 · DOI
This study found that people with ME/CFS have blood clotting abnormalities similar to those seen in Long COVID. Researchers discovered that ME/CFS patients have overactive platelets (blood cells involved in clotting) and tiny clots made of a protein called fibrin scattered throughout their blood plasma. These microscopic clots may block small blood vessels and reduce oxygen delivery to tissues, potentially explaining fatigue and other ME/CFS symptoms.
This research identifies objective, measurable biomarkers in ME/CFS blood that could improve diagnosis and understanding of disease mechanisms. The findings suggest that existing anticoagulant or antiplatelet drugs might help reduce symptoms, potentially opening new treatment avenues for patients with limited therapeutic options.
This study does not prove that fibrinaloid microclots directly cause ME/CFS symptoms—it only shows a correlation between their presence and the disease. The research is observational and cannot establish whether microclots are a primary cause, secondary consequence, or coincidental finding. It also does not demonstrate that treating these clotting abnormalities will improve patients' symptoms.
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
Nunes, Jean M, Kruger, Arneaux, Proal, Amy, Kell, Douglas B, & Pretorius, Etheresia (2022). The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).. Pharmaceuticals (Basel, Switzerland). https://doi.org/10.3390/ph15080931
BibTeX
@article{mecfsatlas-nunes-2022-occurrence-hyperactivated,
author = {Nunes, Jean M and Kruger, Arneaux and Proal, Amy and Kell, Douglas B and Pretorius, Etheresia},
title = {The Occurrence of Hyperactivated Platelets and Fibrinaloid Microclots in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).},
journal = {Pharmaceuticals (Basel, Switzerland)},
year = {2022},
doi = {10.3390/ph15080931},
note = {PubMed: 36015078},
url = {https://www.mecfsatlas.com/evidence/nunes-2022-occurrence-hyperactivated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/nunes-2022-occurrence-hyperactivated
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