Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols

Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A. C. Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I.

doi:10.1300/j092v11n01_02

Cited by 1,180Fibromyalgia and Chronic Fatigue Syndrome ResearchLong-Term Effects of COVID-19Infectious Encephalopathies and Encephalitis

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols

Carruthers, Bruce M., Jain, Anil Kumar, De Meirleir, Kenny L., Peterson, Daniel L., Klimas, Nancy G., Lerner, A. Martin, Bested, Alison C., Flor-Henry, Pierre +4 more·2003·Journal of Chronic Fatigue Syndrome

DOI 10.1300/j092v11n01_02

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Abstract

Recent years have brought growing recognition of the need for clinical criteria for myalgic encephalomyelitis (ME), which is also called chronic fatigue syndrome (CFS). An Expert Subcommittee of Health Canada established the Terms of Reference, and selected an Expert Medical Consensus Panel representing treating physicians, teaching faculty and researchers. A Consensus Workshop was held on March 30 to April 1,2001 to culminate the review process and establish consensus for a clinical working case definition, diagnostic protocols and treatment protocols. We present a systematic clinical working case definition that encourages a diagnosis based on characteristic patterns of symptom clusters, which reflect specific areas of pathogenesis. Diagnostic and treatment protocols, and a short overview of research are given to facilitate a comprehensive and integrated approach to this illness. Throughout this paper, “myalgic encephalomyelitis” and “chronic fatigue syndrome” are used interchangeably and this illness is referred to as “ME/CFS.”

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ME/CFS was diagnosed according to current research case definitions: fatigue of greater than 6 months duration and at least 4 of 8 symptoms including exercise-induced relapse, myalgia, arthralgia, headache of a new and different type, nonrestorative sleep, cognitive complaints, sore throat, and tender lymph nodes.
“ME/CFS was diagnosed according to current research case definitions1,28: fatigue of greater than 6 months duration and at least 4 of 8 symptoms including exercise-induced relapse, myalgia, arthralgia, headache of a new and different type, nonrestorative sleep, cognitive complaints, sore throat, and tender lymph nodes.”
From Leveraging Prior Knowledge of Endocrine Immune Regulation in the Therapeutically-relevant Phenotyping of Women with Chronic Fatigue Syndrome (2019) · cites this paper as [28]
The Institute of Medicine proposed diagnostic criteria very similar to the Canadian Consensus Criteria.
“The Institute of Medicine [1] has proposed diagnostic criteria which are very similar to the Canadian Consensus Criteria [88].”
From Systematic review of mind‐body interventions to treat myalgic encephalomyelitis/chronic fatigue syndrome (2021) · cites this paper as [88]

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Myalgic encephalomyelitis: International Consensus Criteria
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Gene expression alterations at baseline and following moderate exercise in patients with Chronic Fatigue Syndrome and Fibromyalgia Syndrome
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B-Lymphocyte Depletion in Myalgic Encephalopathy/ Chronic Fatigue Syndrome. An Open-Label Phase II Study with Rituximab Maintenance Treatment
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Neuroinflammation and Cytokines in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Critical Review of Research Methods
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Diagnostic and Treatment Protocols
Meirleir, K. L. D., Peterson, D. L., Klimas, N. G., Bested, A. C., Powles, A. C. P., Sherkey, J. A., S, M. I. V. D., & Dip, G. (2014)
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Authors: Carruthers, B. M., Jain, A. K., De Meirleir, K. L., Peterson, D. L., Klimas, N. G., Lerner, A. M., Bested, A. C., Flor-Henry, P., Joshi, P., Powles, A. C. P., Sherkey, J. A., & van de Sande, M. I.
Affiliations: Ottawa Hospital (CA)
University of Miami (US)
Wayne State University (US)
Sunnybrook Health Science Centre (CA)
University of Alberta (CA)
Memorial University of Newfoundland (CA)
McMaster University (CA)
University Health Network (CA)
Corresponding author: Carruthers, Bruce M.
ORCID: Jain, Anil Kumar
Klimas, Nancy G.
Venue: Journal of Chronic Fatigue Syndrome
Publisher: Informa UK Limited
Published: 2003-01
Volume: 11
Issue: 1
Pages: 7-115
ISSN: 1057-3321 (ISSN-L)
1547-0660
DOI: 10.1300/j092v11n01_02
OpenAlex: W2008087869
Cited by: 1,180
References: 203
Citations by year: 2026: 69 · 2025: 109 · 2024: 105 · 2023: 104 · 2022: 88 · 2021: 94 · 2020: 81 · 2019: 69 · 2018: 52 · 2017: 57 · 2016: 46 · 2015: 70 · 2014: 36 · 2013: 37 · 2012: 23
FWCI: 6.55
Type: journal article
Language: en
Open access: closed
Locations: Journal of Chronic Fatigue Syndrome (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords: chronic fatigue syndrome, clinical case definition, diagnostic criteria, symptom clusters, pathogenesis, treatment protocols, consensus panel, Health Canada

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Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols

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