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Exclusionary conditions

In order to diagnosis ME/CFS, the medical provider needs to rule out other illnesses that might cause similar symptoms, such as untreated hypothyroidism, sleep apnea, narcolepsy, malignancies, leukemia, unresolved hepatitis, multiple sclerosis, juvenile rheumatoid arthritis, lupus erythematosus, HIV/AIDS, severe obesity, Lyme disease,  or celiac disease. Most of these can be ruled out with medical testing. Some active psychiatric conditions, such as schizophrenia or major depressive disorder, might explain fatigue but are unlikely to explain other physical symptoms, such as post-exertional malaise. The child may also suffer from a concomitant disorder, such as fibromyalgia (FM) or irritable bowel syndrome (IBS); these do not exclude a diagnosis of ME/CFS.