Post-exertional malaise

Post-exertional malaise (PEM) is one of the main symptoms of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).[1][2] PEM can be described as "a delayed and significant exacerbation of ME/CFS symptoms that always follows physical activity and often follows cognitive activity".[3]

PEM is considered a cardinal symptom by a number of the different diagnostic criteria for ME/CFS, including the International Consensus Criteria (ICC).[4][5][6] The Canadian Consensus Criteria (CCC) does not consider PEM compulsory, rather it requires "post exertional malaise and/or [post exertional] fatigue".[7][8] The National Academy of Medicine's (NAM) Systemic Exertion Intolerance Disease (SEID) criteria (also called IOM 2015 Diagnostic Criteria) requires PEM.[9][10][11] The Centers for Disease Control and Prevention (CDC) use the SEID/IOM 2015 Diagnostic Criteria on its website's ME/CFS page and list PEM as a primary symptom.[10][12]

References
  1. "Unravelling the nature of post-exertional malaise in myalgic encephalomyelitis/chronic fatigue syndrome: The role of elastase, complement C4a and interleukin-1β". ME Research UK. Retrieved 23 September 2017.
  2. Jason, Leonard A.; Evans, Meredyth; So, Suzanna; Scott, Jilian; Brown, Abigail (13 January 2015). "Problems in Defining Post-Exertional Malaise". Journal of Prevention & Intervention in the Community. 43 (1): 20–31. doi:10.1080/10852352.2014.973239. PMC 4295644. PMID 25584525.
  3. "Comments Post-exertional malaise in ME/CFS: Medical Research Council announces new neuroimaging research". ME Association. 16 October 2015. Retrieved 23 September 2017.
  4. "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): Symptoms". Centers for Disease Control and Prevention. U.S. Department of Health & Human Services. 14 July 2017. Retrieved 23 September 2017.
  5. Carruthers, B. M.; van de Sande, M. I.; De Meirleir, K. L.; Klimas, N. G.; Broderick, G.; Mitchell, T.; Staines, D.; Powles, A. C. P.; Speight, N.; Vallings, R.; Bateman, L.; Baumgarten-Austrheim, B.; Bell, D. S.; Carlo-Stella, N.; Chia, J.; Darragh, A.; Jo, D.; Lewis, D.; Light, A. R.; Marshall-Gradisbik, S.; Mena, I.; Mikovits, J. A.; Miwa, K.; Murovska, M.; Pall, M. L.; Stevens, S. (October 2011). "Myalgic encephalomyelitis: International Consensus Criteria". Journal of Internal Medicine. 270 (4): 327–338. doi:10.1111/j.1365-2796.2011.02428.x. PMC 3427890. PMID 21777306.
  6. Maes, Michael; Anderson, George; Morris, Gerwyn; Berk, Michael (27 February 2013). "Diagnosis of myalgic encephalomyelitis: where are we now?". Expert Opinion on Medical Diagnostics. 7 (3): 221–225. doi:10.1517/17530059.2013.776039.
  7. Myhill S, Booth NE, McLaren-Howard J; Booth; McLaren-Howard (2009). "Chronic fatigue syndrome and mitochondrial dysfunction" (PDF). Int J Clin Exp Med. 2 (1): 1–16. PMC 2680051. PMID 19436827.CS1 maint: multiple names: authors list (link)
  8. Carruthers, Bruce M; van de Sande, Marjorie I. "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners" (PDF). sacfs.asn.au. p. 8. There is an inappropriate loss of physical and mental stamina, rapid muscular and cognitive fatigability, post exertional malaise and/or fatigue and/or pain and a tendency for other associated symptoms within the patient's cluster of symptoms to worsen.
  9. "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Key Facts" (PDF). nap.edu. 2015. p. 2.
  10. "IOM 2015 Diagnostic Criteria | Diagnosis | Healthcare Providers | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC". www.cdc.gov. 2018-11-08. Retrieved 2019-03-08.
  11. Wright Clayton, Ellen; Alegria, Margarita; Bateman, Lucinda; Chu, Lily; Cleeland, Charles; Davis, Ronald; Diamond, Betty; Ganlats, Theodore; Keller, Betsy (2015). "Beyond Myalgic Encephalomyelits/Chronic Fatigue Syndrome: Redefining an Illness (Report Guide for Clinicians)" (PDF). nationalacademies.org. Nancy Klimas, A. Martin Lerner, Cynthia Mulrow, Benjamin Natelson, Peter Rowe, Michael Shelanski. National Academy of Medicine (Institutes of Medicine). p. 7.
  12. "Symptoms of ME/CFS | Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) | CDC". www.cdc.gov. 2019-01-18. Retrieved 2019-03-08.


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