title: [Chronic fatigue--'tired with 23 i's'].
abstract: Two patients, a woman aged 32 years and a man aged 49, presented with severe chronic fatigue. The woman had chronic fatigue syndrome; she recovered slowly. The man suffered from a pituitary adenoma producing follicle stimulating hormone; he recovered after transsphenoidal hypophysectomy. In patients with chronic fatigue, the history and a thorough physical examination to exclude underlying illness are very important; secondary symptom criteria must not be overemphasized (as is the case with the Holmes and Fukuda criteria), chronic fatigue syndrome should not be diagnosed if the condition has a shorter duration than 6 months, but it should be diagnosed if the clinical picture is compatible. The prognosis is not poor: in patients with a median disease duration of 4.5 years, 20% show significant improvement over an 18-month period.
authors.affiliation: Academisch Ziekenhuis, afd. Algemeen Interne Geneeskunde, Nijmegen.
authors.forename: J W
authors.initials: JW
authors.lastname: van der Meer
authors.forename: L D
authors.initials: LD
authors.lastname: Elving
mesh_terms: D000328:Adult; D001247:Asthenia / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology*; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000378:metabolism
chemical_list: D005640:Follicle Stimulating Hormone