ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. F43G93ArtikelübersichtFatigue syndrome
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Fatigue syndrome: description
The term "fatigue" comes from French and linguistic usage and means fatigue or exhaustion. Thus, the fatigue syndrome characterized by a persistent feeling of fatigue, exhaustion and listlessness, which can not be driven away by much sleep and rest. The life of those affected is permanently impaired by the permanent, extreme weariness.
How often the fatigue syndrome occurs can not be said exactly. There are corresponding studies on the occurrence of chronic fatigue in the context of various diseases. However, these are usually based only on the subjective information of patients. Nevertheless, it is striking how often chronic fatigue is indicated as a distressing symptom. Thus, significantly more than half of all patients with multiple sclerosis (MS) suffer from fatigue. In Parkinson's patients, the proportion of those affected varies between 43 and 60 percent depending on the study; in cancer patients, he should even be more than 90 percent, experts estimate.
Fatigue is often confused with an autonomic neurological disorder called Chronic Fatigue Syndrome (CFS). However, both the causes and the physical signs differ in part but clearly.
Overall, representative studies show that the incidence of fatigue increases with age and women are more frequently affected than men.To the table of contents
Fatigue syndrome: symptoms
The fatigue syndrome manifests itself in an insurmountable, persistent sense of physical and / or mental fatigue. Those affected feel less physically and mentally than before: even "normal" physical activities such as brushing their teeth, cooking, making phone calls, attention and memory are often perceived as hardly feasible. After such activities, fatigue patients feel disproportionately exhausted. A key feature of fatigue is that extreme tiredness and fatigue can not be alleviated by a lot of sleep - those affected go to sleep exhausted and get up the next morning just as beaten up.
Fatigue, which goes far beyond normal levels, often results in those affected withdrawing and further restricting their professional and personal activities.To the table of contents
Fatigue syndrome: causes and risk factors
There are basically three types of fatigue:
- Fatigue as a concomitant of chronic diseases such as cancer, multiple sclerosis, Parkinson's disease, systemic lupus erythematosus, rheumatoid arthritis ("rheumatism") or HIV / AIDS
- Fatigue as a result of other conditions such as severe sleep disturbances, nocturnal breathing (sleep apnea), persistent pain, thyroid disease, anemia, malnutrition, interferon treatment (in multiple sclerosis, hepatitis C or certain cancers) or chemotherapy (in cancer)
- Fatigue as a Disease - Physicians speak of Chronic Fatigue Syndrome (CFS)
In some cases, the triggering factors of fatigue are known. For example, in the case of anemia (anemia), the number of red blood cells responsible for oxygen transport is reduced. As a result, the body cells get too little oxygen, which among other things leads to loss of performance and fatigue.
In contrast, the development of fatigue as a concomitant chronic disease is still unclear in most cases. Experts suspect that there is no single trigger for the ongoing fatigue, but rather that several factors contribute to fatigue (fatigue as a multifactorial event). Suspects include:
- Changes within the central nervous system (as in Parkinson's disease and multiple sclerosis)
- Changes in the endocrine system (hormone balance)
- Dysregulation of the immune system (fatigue is a common symptom of autoimmune diseases such as multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus!)
- Inflammatory processes (as in rheumatoid arthritis and fibromyalgia)
Fatigue in cancer
The best studied is the tumor-related fatigue, ie a prolonged exhaustion as a concomitant and sequelae of cancer. Again, there are several factors in the development of fatigue, experts believe:
The cancer itself: The tumor can cause changes in the body that lead to fatigue. For example, cancer cells can produce substances that cause fatigue and fatigue. Suspected are the cytokines - certain proteins of the body. Some cancers increase energy demands, weaken muscles, or interfere with hormonal circuits - all these factors can contribute to fatigue.
The cancer treatment: Surgery, chemotherapy, radiation, immunotherapy and bone marrow transplantation can all cause fatigue. For example, chemotherapy not only destroys cancer cells, but also healthy cells and tissues, such as immune cells. A reduction in red blood cells (erythrocytes) leads to anemia (anemia) - this is considered the main cause of fatigue. Reduction of white blood cells (leukocytes) increases susceptibility to infections, which also weakens the body.
Cancer also has other side effects such as nausea, vomiting, pain, insomnia and mental health problems - they are also considered (co-) causes of fatigue.
Other factors: The psyche also plays a role in cancer and the associated fatigue. Cancer diagnosis and therapy can trigger stress, anxiety, depression and sleep disorders. In addition, medications (such as painkillers), nutritional deficiencies and a deficit in physical training can contribute to fatigue. The same applies to hormonal changes in the course of cancer treatment, such as changes in the thyroid, adrenal or sex hormones.To the table of contents
Fatigue syndrome: examinations and diagnosis
To clarify an inexplicable fatigue, the doctor first asks the medical history (anamnesis). It is important, for example, since when the exhaustion exists, how pronounced it is and how much it interferes with everyday life. In addition, the doctor inquired about further complaints, sleep patterns, the intake of medication, the consumption of alcohol, caffeine, nicotine and possibly illegal drugs and the professional, family and social situation.
This is followed by a physical examination, including a blood test. It can, for example, expose anemia (anemia) as a trigger of fatigue.
Fatigue is a subjective symptom. However, there are a number of procedures (questionnaires, scales) that help the doctor to detect exhaustion more objectively.
Important in the clarification of fatigue is the demarcation to depression, because this can cause a strong tiredness and listlessness.