Tag: differential diagnosis

Endocrinopathy in the differential diagnosis of chronic fatigue syndrome

Abstract:

Fatigue is a frequent and sometimes dominant symptom of some endocrinopathies. It may be associated with other symptoms which are included among the criteria of the chronic fatigue syndrome. These units are not always quite distinct and frequently endocrine diseases and chronic fatigue syndrome (CFS) overlap. From this ensue differential diagnostic problems and ideas on possible causal relations.

The authors concentrate in particular on autoimmune endocrinopathies and the polyglandular autoimmune syndrome (APS) with emphasis on the necessity of an accurate endocrinological diagnosis, where is some patients with suspected CFS a defined endocrinopathy was revealed.

Attention will be also paid to recent views on the possible participation of disorders of the hypothalamus-pituitary-adrenal axis in the etiopathogenesis of CFS where endocrine and immune regulation overlap and condition each other.

 

Source: Sterzl I, Zamrazil V. Endocrinopathy in the differential diagnosis of chronic fatigue syndrome. Vnitr Lek. 1996 Sep;42(9):624-6. [Article in Czech] http://www.ncbi.nlm.nih.gov/pubmed/8984770

 

Differential diagnosis of chronic fatigue in children: behavioral and emotional dimensions

Abstract:

A battery of self-report questionnaires and structured diagnostic interviews was administered to 20 children and adolescents who presented to a pediatric specialty clinic with chronic fatigue. Matched groups of healthy and depressed control subjects (aged 8 to 19 years) were also studied. Criteria were established to identify those items in the assessment battery that reliably differentiated among the three groups.

Analysis of item content suggested several clusters of characteristics that discriminated among the subject groups, including life changes, cognitive difficulties, negative self-attributions, social relationship disruption, and somatic symptom presentation.

The results suggest that certain psychological factors can discriminate chronic fatigue from depressive symptomatology, as well as normal functioning. Items discriminating among groups are presented in an organized questionnaire format to assist with the understanding and assessment of pediatric chronic fatigue cases.

 

Source: Carter BD, Kronenberger WG, Edwards JF, Michalczyk L, Marshall GS. Differential diagnosis of chronic fatigue in children: behavioral and emotional dimensions. J Dev Behav Pediatr. 1996 Feb;17(1):16-21. http://www.ncbi.nlm.nih.gov/pubmed/8675709

 

Chronic fatigue syndrome and psychiatric diseases

Abstract:

The chronic fatigue syndrome consists of a combination of non-specific symptoms. Some believe that the CFS is subcategory of major depression, because the symptoms are similar to those of major depression. We believe that the CFS is quite different from major depression or neurotic depression, since the CFS has no lack of initiative and effort, no inhibition which is seen in endogenous depression, and sharp fluctuations in general fatigue, anxiety, and various persisting somatic symptoms, such as, malaise and mild fever. CFS seems to be similar to the neurasthenia. It is harmful, at least, in aetiology and treatment, to neglect the diagnosis of the CFS.

 

Source: Matsuno T, Hikita K, Matsuo T. Chronic fatigue syndrome and psychiatric diseases. Nihon Rinsho. 1994 May;52(5):1339-44. [Article in Japanese] http://www.ncbi.nlm.nih.gov/pubmed/8007411

 

Consideration of narcolepsy in the differential diagnosis of chronic fatigue syndrome

Abstract:

OBJECTIVE: To justify the inclusion of narcolepsy in the differential diagnosis of patients with chronic fatigue.

CLINICAL FEATURES: We report three patients aged 17 (two women and one man) and one woman aged 45 who had been diagnosed as having chronic fatigue syndrome (CFS). They had no psychiatric illness. Their main problem was severe daytime sleepiness, presenting as “tiredness and fatigue”. The history, sleep study and multiple sleep latency test suggested a diagnosis of narcolepsy.

INTERVENTION: Treatment with methylphenidate resulted in complete resolution of symptoms in two patients and significant improvement in the other two.

CONCLUSIONS: The differential diagnosis of CFS requires the exclusion of other conditions. If daytime sleepiness is a major complaint, other symptoms of narcolepsy should be sought and the diagnosis confirmed with sleep study and a multiple sleep latency test.

 

Source: Ambrogetti A, Olson LG. Consideration of narcolepsy in the differential diagnosis of chronic fatigue syndrome. Med J Aust. 1994 Apr 4;160(7):426-9. http://www.ncbi.nlm.nih.gov/pubmed/8007866

 

Primary fibromyalgia and the chronic fatigue syndrome

Abstract:

Thirty-three primary fibromyalgia patients were investigated for chronic fatigue syndrome symptoms. Significant fatigue was reported by 21/33 patients (63.6%), and patients reported various flulike symptoms, yet only 7/33 patients (21.2%) fulfilled criteria for the chronic fatigue syndrome. Only one patient reported painful lymph glands and four patients reported fever. Thus, symptoms of painful glands or fever might serve as clinical indicators, distinguishing between fibromyalgia and the chronic fatigue syndrome.

 

Source: Wysenbeek AJ, Shapira Y, Leibovici L. Primary fibromyalgia and the chronic fatigue syndrome. Rheumatol Int. 1991;10(6):227-9. http://www.ncbi.nlm.nih.gov/pubmed/2041979