Sharif, Kassem, Watad, Abdulla, Bragazzi, Nicola Luigi et al. · Clinical rheumatology · 2018 · DOI
This paper reviews the history of ME/CFS and explores whether it might be related to autoimmune diseases—conditions where the immune system mistakenly attacks the body. The authors discuss how ME/CFS has been called many different names over the past 300 years and how its symptoms overlap with other conditions like POTS and Sjögren's syndrome. They suggest that ME/CFS might be an early stage of an autoimmune disease or might share underlying causes with autoimmune conditions.
Understanding whether ME/CFS is related to autoimmune diseases could help researchers develop better diagnostic criteria and targeted treatments. This historical perspective helps validate patient experiences by showing that these symptoms have been recognized for centuries under different names, and it highlights the need for researchers to investigate connections between ME/CFS and conditions like POTS and autoimmune disorders.
This review does not prove that ME/CFS is an autoimmune disease or a precursor to one—it presents hypotheses and observations from existing literature rather than new experimental evidence. The paper cannot establish causation or definitively categorize ME/CFS, and the overlap between conditions may reflect shared symptoms rather than shared mechanisms. The historical naming conventions reviewed do not necessarily indicate these were the same disease.
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
Sharif, Kassem, Watad, Abdulla, Bragazzi, Nicola Luigi, Lichtbroun, Michael, Martini, Mariano, Perricone, Carlo, et al. (2018). On chronic fatigue syndrome and nosological categories.. Clinical rheumatology. https://doi.org/10.1007/s10067-018-4009-2
BibTeX
@article{mecfsatlas-sharif-2018-chronic-fatigue,
author = {Sharif, Kassem and Watad, Abdulla and Bragazzi, Nicola Luigi and Lichtbroun, Michael and Martini, Mariano and Perricone, Carlo and Amital, Howard and Shoenfeld, Yehuda},
title = {On chronic fatigue syndrome and nosological categories.},
journal = {Clinical rheumatology},
year = {2018},
doi = {10.1007/s10067-018-4009-2},
note = {PubMed: 29417255},
url = {https://www.mecfsatlas.com/evidence/sharif-2018-chronic-fatigue},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/sharif-2018-chronic-fatigue
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