Differential diagnosis

Differential diagnosis in ME/CFS is the process which tries to make a correct diagnosis by excluding other diseases which can cause similar symptoms, for example other fatiguing or painful illness.

ME/CFS

Many diseases can cause similar symptoms ME/CFS:

• infectious diseases (such as Epstein–Barr virus, influenza, HIV infection, tuberculosis, Lyme disease)
• connective tissue diseases (such as Ehlers-Danlos Syndrome)
• immunological diseases [such as Mast Cell Activation Syndrome (MCAS), primary immunodeficiency (PI), Common Variable Immunodeficiency (CVID)]
• neurological conditions [such as Postural Orthostatic Tachycardia Syndrome (POTS), Orthostatic Intolerance, Cerebral spinal fluid leaks (CSF leaks), Craniocervical instability (CCI), vestibular migraines]
• neuroendocrine diseases [such as Hashimoto's thyroiditis (hypothyroidism), Addison's disease, adrenal insufficiency, Cushing's disease]
• hematologic diseases (such as occult malignancy, lymphoma)
• rheumatologic diseases (such as fibromyalgia, polymyalgia rheumatica, Sjögren's syndrome, giant-cell arteritis, polymyositis, dermatomyositis)
• psychiatric diseases (such as depression, bipolar disorder, schizophrenia, delusional disorders, dementia, anorexia/bulimia nervosa)
• neuropsychologic diseases (such as obstructive sleep apnea, parkinsonism, multiple sclerosis)
• others (such as nasal obstruction from allergies, sinusitis, anatomic obstruction, autoimmune diseases such as lupus or rheumatoid arthritis, some other chronic illness, alcohol or substance abuse, pharmacologic side effects, heavy metal exposure and toxicity, marked body weight fluctuation)

However, if strict diagnostic criteria and diagnostic testing for other conditions is used, misdiagnosing a patient suffering from the conditions above with ME/CFS is unlikely.

Multiple Sclerosis

Neurological symptoms, such as POTS symptoms and dysautonomia are very common in ME/CFS patients, those same symptoms are common in M.S. as well. Furthermore M.S. can often present with fatigue and post-exertional malaise.

Notable studies

• 2021, Clinical Profile and Aspects of Differential Diagnosis in Patients with ME/CFS from Latvia - (Full text)
• 2000, Differential diagnosis: The challenge of chronic fatigue - (Full text)

See also

• List of differential diagnoses for ME/CFS
• Comorbidities of Myalgic Encephalomyelitis
• Misdiagnosis of myalgic encephalomyelitis and chronic fatigue syndrome
• Definitions of myalgic encephalomyelitis and chronic fatigue syndrome - diagnostic criteria

postural orthostatic tachycardia syndrome (POTS) - A form of orthostatic intolerance where the cardinal symptom is excessive tachycardia due to changing position (e.g. from lying down to sitting up).

postural orthostatic tachycardia syndrome (POTS) - A form of orthostatic intolerance where the cardinal symptom is excessive tachycardia due to changing position (e.g. from lying down to sitting up).

orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).

cerebral 1. of or relating to the brain or the intellect 2. of, relating to, affecting, or being the cerebrum.

neuroendocrine relating to hormones that influence the nervous system

adverse reaction Any unintended or unwanted response to a treatment, whether in a clinical trial or licensed treatment. May be minor or serious.