Chronic fatigue syndrome
Description | 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 |