Article

Fatigue is a prominent symptom in many rheumatic diseases. Numerous factors
contribute to cause fatigue, which can be a source of frustration for the
patients and physicians, as the treatment often fails to produce the desired
improvement. Diagnostic guidelines direct insufficient attention to the various
semiological patterns of fatigue seen in rheumatic diseases. This update
describes three main patterns of fatigue, depending on whether the source is
physical or mental: muscle weakness in patients with neuromuscular disease;
asthenia related to organic disease with excessive energy expenditure, deficient
energy production (e.g., endocrine disorders), or inadequate recovery; and
weariness due to the impact of stress and depression on quality of life. The
prevalence of each pattern in various rheumatic diseases is discussed. This
update underlines the practical benefits provided by a detailed semiological
analysis of fatigue in patients with rheumatic disease and emphasizes the marked
predominance of weariness due to stress and depression, on which the personality
of the patient and inadequacy of social support systems may exert a major
influence. Serotonin reuptake inhibitors (SSRIs) may be valuable in patients with
fatigue not only because they improve the mental status, but also via their
recently demonstrated anti-inflammatory effects.
CI - Copyright (c) 2010 Societe francaise de rhumatologie. Published by Elsevier SAS.
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Langue : ANGLAIS