Abstract:
Two patients, a woman aged 32 years and a man aged 49, presented with severe chronic fatigue. The woman had chronic fatigue syndrome; she recovered slowly. The man suffered from a pituitary adenoma producing follicle stimulating hormone; he recovered after transsphenoidal hypophysectomy.
In patients with chronic fatigue, the history and a thorough physical examination to exclude underlying illness are very important; secondary symptom criteria must not be overemphasized (as is the case with the Holmes and Fukuda criteria), chronic fatigue syndrome should not be diagnosed if the condition has a shorter duration than 6 months, but it should be diagnosed if the clinical picture is compatible.
The prognosis is not poor: in patients with a median disease duration of 4.5 years, 20% show significant improvement over an 18-month period.
Comment in:
Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997
Chronic fatigue syndrome. Ned Tijdschr Geneeskd. 1997
Source: van der Meer JW, Elving LD. Chronic fatigue–‘tired with 23 i’s’. Ned Tijdschr Geneeskd. 1997 Aug 2;141(31):1505-7. [Article in Dutch] http://www.ncbi.nlm.nih.gov/pubmed/9543734