Varied Presentation of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and the Needs for Classification and Clinician Education: A Case Series

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex, heterogeneous and serious disease. In this article, we analyze the cases of 3 patients with ME/CFS. Due to the disbeliefs, misconceptions, and stigmas that are attached to ME/CFS, patient diagnosis is made after years of disease progression. Over this period, physicians tried to determine the etiology of the disease, taking into account its onset and symptoms. The suspected conditions correlated with possible subgroups that researchers speculate may exist in ME/CFS. Therefore, a registry of well-selected data on clinical history could help to cluster patients into more homogenous groups, and could be beneficial for research.The authors thank Francisco Cuesta and Elena Martín- Martín for English-language editing. Written informed consent for the publication of each case report was obtained from each patient. E. Martín-Martínez conceived of this case report, revised it critically for intellectual content, conducted the literature review, drafted the manuscript, and gave final approval of the version to be published. M. Martín-Martínez contributed to manuscript writing and preparation.Peer Reviewe