van Eeden, Charmaine, Osman, Mohammed S, Cohen Tervaert, Jan Willem · Expert review of clinical immunology · 2022 · DOI
This review examined severe, long-lasting fatigue in patients with certain autoimmune diseases and compared it to ME/CFS. The researchers found that fatigue in these autoimmune diseases shares similarities with ME/CFS, including common immune and metabolic problems. Importantly, this fatigue often persists even after the main disease is brought under control, suggesting it may need different treatment approaches than the underlying condition.
This review is significant because it formally recognizes that ME/CFS-like fatigue occurs in other autoimmune conditions and shares biological mechanisms, validating ME/CFS as a distinct clinical entity worthy of specialized investigation. For ME/CFS patients, it suggests that successful disease remission should not be the only treatment goal—fatigue itself requires targeted intervention. It also establishes that physicians should screen SARD patients for ME/CFS features, potentially improving outcomes for many overlooked patients.
This review does not prove that ME/CFS is caused by autoimmune diseases or vice versa; it identifies similar pathways without establishing causality. It does not define the exact mechanisms causing fatigue or provide evidence that specific treatments proven for one condition will work for others. The review synthesizes existing literature, so its conclusions depend on the quality and comprehensiveness of the underlying studies reviewed.
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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