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There are summarized in Figure 4

H.GoodarziN.CheraghiH.BakhtiariM.et al (2024)

Recognising these early can help ensure timely medical attention

Following exercise or exertion, patients with ME/CFS exhibit elevated levels of pro-inflammatory cytokines in peripheral blood, accompanied by muscle fatigue, exhaustion, and cognitive impairments, indicating that mitochondrial-driven inflammatory signaling may be a potential key driver of PEM symptoms (69)