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Alternatively, if the elevated anion gap persists despite cessation of acetaminophen and administration of N-acetylcysteine, pyroglutamic acidosis is unlikely, and an alternative diagnosis should be sought

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3.5.1 Background CFS, also known as Myalgic Encephalomyelitis (CFS/ME), is a complex disorder marked by persistent fatigue, cognitive impairment, and a range of physical symptoms that are not alleviated by rest (König et al., 2021