Indications directory

Pathogenesis is unclear. Suspicion of excessive cytokine-release. Endocrinologic low cortisol level with high ACTH.

Basic evaluations:

ESR or CRP, full blood count, glucose, GOT, GPT, gamma-GT, creatinine, urea, sodium, potassium, calcium, iron, magnesium, CK, urine status- and sedimentation, ferritin, selenium, zinc

Further evaluations for etiological evaluation:

Infection serology:

EBV, borrelia, CMV, if necessary HIV (consent required), herpes-virus type 6 (HHV-6)

Immunology:

Immune globulins, ANA, cardiolipin-antibodies

Endocrinology:

TSH, T3, T4, prolactin (on suspicion of prolactinoma), cortisol, ACTH (on suspicion of adrenal insufficiency, frozen EDTA-plasma required), testosterone (on suspicion of male hypogonadism), vitamin D

HLA:

HLA-DR2 (on suspicion of narcolepsy)

Depending on the clinical picture also:

Vasculitis, myalgia, arthritis, myocarditis, diarrhea, hepatitis, gastritis, exanthema, lymphadenitis, pneumonia, immune defects (see there), if necessary neuropsychiatric assessment