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Chronic fatigue

MedGen UID:
760077
Concept ID:
C0518656
Finding
Synonym: Chronic extreme exhaustion
 
HPO: HP:0012432

Definition

Subjective feeling of tiredness characterized by a lack of energy and motivation that persists for six months or longer. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • Chronic fatigue

Conditions with this feature

Familial amyloid nephropathy with urticaria AND deafness
MedGen UID:
120634
Concept ID:
C0268390
Disease or Syndrome
Muckle-Wells syndrome (MWS) is characterized by episodic skin rash, arthralgias, and fever associated with late-onset sensorineural deafness and renal amyloidosis (Dode et al., 2002).
Familial pulmonary capillary hemangiomatosis
MedGen UID:
90956
Concept ID:
C0340848
Disease or Syndrome
Pulmonary venoocclusive disease-2 is an autosomal recessive subtype of primary pulmonary hypertension (PPH; see 178600). It is characterized histologically by widespread fibrous intimal proliferation of septal veins and preseptal venules, and is frequently associated with pulmonary capillary dilatation and proliferation. The disorder can cause occult alveolar hemorrhage. High-resolution CT imaging of the chest shows patchy centrilobular ground-glass opacities, septal lines, and lymph node enlargement (summary by Eyries et al., 2014). For a discussion of genetic heterogeneity of pulmonary venoocclusive disease, see PVOD1 (265450).
Gaucher disease due to saposin C deficiency
MedGen UID:
350479
Concept ID:
C1864651
Disease or Syndrome
Any Gaucher disease in which the cause of the disease is a mutation in the PSAP gene.
Aneurysm-osteoarthritis syndrome
MedGen UID:
462437
Concept ID:
C3151087
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Loeys-Dietz syndrome 1
MedGen UID:
1646567
Concept ID:
C4551955
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.
Ehlers-Danlos syndrome, classic-like, 2
MedGen UID:
1632001
Concept ID:
C4693870
Disease or Syndrome
Ehlers-Danlos syndrome classic-like-2 (EDSCLL2) is characterized by severe joint and skin laxity, osteoporosis involving the hips and spine, osteoarthritis, soft redundant skin that can be acrogeria-like, delayed wound healing with abnormal atrophic scarring, and shoulder, hip, knee, and ankle dislocations. Variable features include gastrointestinal and genitourinary manifestations, such as bowel rupture, gut dysmotility, cryptorchidism, and hernias; vascular complications, such as mitral valve prolapse and aortic root dilation; and skeletal anomalies (Blackburn et al., 2018). For a discussion of genetic heterogeneity of classic-like Ehlers-Danlos syndrome, see 606408. For a discussion of the classification of EDS, see 130000.
Bone marrow failure syndrome 6
MedGen UID:
1717739
Concept ID:
C5394274
Disease or Syndrome
Immunodeficiency 70
MedGen UID:
1740270
Concept ID:
C5436501
Disease or Syndrome
Immunodeficiency-70 (IMD70) is an autosomal dominant immunologic disorder characterized by severe cutaneous warts on the hands, feet, and face, suggesting increased susceptibility to human papillomavirus (HPV) infection. Affected individuals may also have recurrent bacterial infections, such as sinusitis, as well as feature of autoinflammation, such as colitis, celiac disease, and retinal vasculitis. Laboratory studies show decreased CD4+ T cells and decreased CD19+ B cells; hypogammaglobulinemia has also been observed (summary by Thaventhiran et al., 2020).
Loeys-Dietz syndrome 6
MedGen UID:
1794251
Concept ID:
C5562041
Disease or Syndrome
Loeys-Dietz syndrome (LDS) is characterized by vascular findings (cerebral, thoracic, and abdominal arterial aneurysms and/or dissections), skeletal manifestations (pectus excavatum or pectus carinatum, scoliosis, joint laxity, arachnodactyly, talipes equinovarus, cervical spine malformation and/or instability), craniofacial features (widely spaced eyes, strabismus, bifid uvula / cleft palate, and craniosynostosis that can involve any sutures), and cutaneous findings (velvety and translucent skin, easy bruising, and dystrophic scars). Individuals with LDS are predisposed to widespread and aggressive arterial aneurysms and pregnancy-related complications including uterine rupture and death. Individuals with LDS can show a strong predisposition for allergic/inflammatory disease including asthma, eczema, and reactions to food or environmental allergens. There is also an increased incidence of gastrointestinal inflammation including eosinophilic esophagitis and gastritis or inflammatory bowel disease. Wide variation in the distribution and severity of clinical features can be seen in individuals with LDS, even among affected individuals within a family who have the same pathogenic variant.

Professional guidelines

PubMed

Grach SL, Seltzer J, Chon TY, Ganesh R
Mayo Clin Proc 2023 Oct;98(10):1544-1551. doi: 10.1016/j.mayocp.2023.07.032. PMID: 37793728
Bateman L, Bested AC, Bonilla HF, Chheda BV, Chu L, Curtin JM, Dempsey TT, Dimmock ME, Dowell TG, Felsenstein D, Kaufman DL, Klimas NG, Komaroff AL, Lapp CW, Levine SM, Montoya JG, Natelson BH, Peterson DL, Podell RN, Rey IR, Ruhoy IS, Vera-Nunez MA, Yellman BP
Mayo Clin Proc 2021 Nov;96(11):2861-2878. Epub 2021 Aug 25 doi: 10.1016/j.mayocp.2021.07.004. PMID: 34454716
Dukes JC, Chakan M, Mills A, Marcaurd M
Med Clin North Am 2021 Jan;105(1):137-148. doi: 10.1016/j.mcna.2020.09.007. PMID: 33246515

Recent clinical studies

Etiology

Sotzny F, Blanco J, Capelli E, Castro-Marrero J, Steiner S, Murovska M, Scheibenbogen C; European Network on ME/CFS (EUROMENE)
Autoimmun Rev 2018 Jun;17(6):601-609. Epub 2018 Apr 7 doi: 10.1016/j.autrev.2018.01.009. PMID: 29635081
Cleare AJ, Reid S, Chalder T, Hotopf M, Wessely S
BMJ Clin Evid 2015 Sep 28;2015 PMID: 26415100Free PMC Article
Reid S, Chalder T, Cleare A, Hotopf M, Wessely S
BMJ Clin Evid 2011 May 26;2011 PMID: 21615974Free PMC Article
Reid SF, Chalder T, Cleare A, Hotopf M, Wessely S
BMJ Clin Evid 2008 Aug 28;2008 PMID: 19445810Free PMC Article
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A
Ann Intern Med 1994 Dec 15;121(12):953-9. doi: 10.7326/0003-4819-121-12-199412150-00009. PMID: 7978722

Diagnosis

Grach SL, Seltzer J, Chon TY, Ganesh R
Mayo Clin Proc 2023 Oct;98(10):1544-1551. doi: 10.1016/j.mayocp.2023.07.032. PMID: 37793728
Turner-Stokes L, Wade DT
BMJ 2020 Dec 16;371:m4774. doi: 10.1136/bmj.m4774. PMID: 33328173
Bested AC, Marshall LM
Rev Environ Health 2015;30(4):223-49. doi: 10.1515/reveh-2015-0026. PMID: 26613325
Yancey JR, Thomas SM
Am Fam Physician 2012 Oct 15;86(8):741-6. PMID: 23062157
Fukuda K, Straus SE, Hickie I, Sharpe MC, Dobbins JG, Komaroff A
Ann Intern Med 1994 Dec 15;121(12):953-9. doi: 10.7326/0003-4819-121-12-199412150-00009. PMID: 7978722

Therapy

Barletta MA, Marino G, Spagnolo B, Bianchi FP, Falappone PCF, Spagnolo L, Gatti P
Clin Exp Med 2023 Jul;23(3):667-678. Epub 2022 Aug 22 doi: 10.1007/s10238-022-00871-8. PMID: 35994177Free PMC Article
Castro-Marrero J, Segundo MJ, Lacasa M, Martinez-Martinez A, Sentañes RS, Alegre-Martin J
Nutrients 2021 Jul 30;13(8) doi: 10.3390/nu13082658. PMID: 34444817Free PMC Article
Kim DY, Lee JS, Park SY, Kim SJ, Son CG
J Transl Med 2020 Jan 6;18(1):7. doi: 10.1186/s12967-019-02196-9. PMID: 31906979Free PMC Article
Larun L, Brurberg KG, Odgaard-Jensen J, Price JR
Cochrane Database Syst Rev 2017 Apr 25;4(4):CD003200. doi: 10.1002/14651858.CD003200.pub7. PMID: 28444695Free PMC Article
Goebel A
Autoimmun Rev 2016 Jun;15(6):552-7. Epub 2016 Feb 12 doi: 10.1016/j.autrev.2016.02.011. PMID: 26883460

Prognosis

Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS
Lancet Public Health 2018 Jul;3(7):e323-e332. Epub 2018 Jun 14 doi: 10.1016/S2468-2667(18)30091-4. PMID: 29908859Free PMC Article
McGovern MM, Avetisyan R, Sanson BJ, Lidove O
Orphanet J Rare Dis 2017 Feb 23;12(1):41. doi: 10.1186/s13023-017-0572-x. PMID: 28228103Free PMC Article
Bested AC, Marshall LM
Rev Environ Health 2015;30(4):223-49. doi: 10.1515/reveh-2015-0026. PMID: 26613325
Kakumanu S, Yeager M, Craig TJ
J Am Osteopath Assoc 1999 Oct;99(10 Su Pt 1):S1-5. PMID: 10624375
Klonoff DC
Clin Infect Dis 1992 Nov;15(5):812-23. doi: 10.1093/clind/15.5.812. PMID: 1445980

Clinical prediction guides

Giloteaux L, Li J, Hornig M, Lipkin WI, Ruppert D, Hanson MR
J Transl Med 2023 May 13;21(1):322. doi: 10.1186/s12967-023-04179-3. PMID: 37179299Free PMC Article
Yang T, Yang Y, Wang D, Li C, Qu Y, Guo J, Shi T, Bo W, Sun Z, Asakawa T
J Transl Med 2019 Jun 28;17(1):213. doi: 10.1186/s12967-019-1948-6. PMID: 31253154Free PMC Article
Larun L, Brurberg KG, Odgaard-Jensen J, Price JR
Cochrane Database Syst Rev 2017 Apr 25;4(4):CD003200. doi: 10.1002/14651858.CD003200.pub7. PMID: 28444695Free PMC Article
Fasano A, Sapone A, Zevallos V, Schuppan D
Gastroenterology 2015 May;148(6):1195-204. Epub 2015 Jan 9 doi: 10.1053/j.gastro.2014.12.049. PMID: 25583468
Berelowitz GJ, Burgess AP, Thanabalasingham T, Murray-Lyon IM, Wright DJ
J Viral Hepat 1995;2(3):133-8. doi: 10.1111/j.1365-2893.1995.tb00018.x. PMID: 7493307

Recent systematic reviews

Lepri B, Romani D, Storari L, Barbari V
Int J Environ Res Public Health 2023 Feb 24;20(5) doi: 10.3390/ijerph20054098. PMID: 36901108Free PMC Article
Todorova V, Ivanov K, Delattre C, Nalbantova V, Karcheva-Bahchevanska D, Ivanova S
Nutrients 2021 Aug 20;13(8) doi: 10.3390/nu13082861. PMID: 34445021Free PMC Article
Kim DY, Lee JS, Park SY, Kim SJ, Son CG
J Transl Med 2020 Jan 6;18(1):7. doi: 10.1186/s12967-019-02196-9. PMID: 31906979Free PMC Article
Arring NM, Millstine D, Marks LA, Nail LM
J Altern Complement Med 2018 Jul;24(7):624-633. Epub 2018 Apr 6 doi: 10.1089/acm.2017.0361. PMID: 29624410
Cadegiani FA, Kater CE
BMC Endocr Disord 2016 Aug 24;16(1):48. doi: 10.1186/s12902-016-0128-4. PMID: 27557747Free PMC Article

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