title: Does severe nutcracker phenomenon cause pediatric chronic fatigue?
abstract: BACKGROUND
  In the past five years we experienced 9 fatigued disabled children who were intermittently or persistently absent from school.
  
  
  METHODS
  They had been suspected to be burdened with psychosomatic disorders, having orthostatic hypotension, postural tachycardia, or other autonomic dysfunction symptoms.
  
  
  RESULTS
  Investigating the cause of moderate orthostatic proteinuria in some of them, we found by chance severe typical nutcracker phenomenon (NC), which was present in all 9 children complaining of chronic fatigue.
  
  
  CONCLUSIONS
  Their symptoms filled the criteria of chronic fatigue syndrome or idiopathic chronic fatigue (CFS/CF). An association between severe NC and autonomic dysfunction symptoms in children with CFS/CF has been presented.
authors.affiliation: Department of Pediatrics, Tenri Hospital, Nara, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Takahashi
authors.forename: S
authors.initials: S
authors.lastname: Ohta
authors.forename: A
authors.initials: A
authors.lastname: Sano
authors.forename: Y
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Y
authors.initials: Y
authors.lastname: Kaji
authors.forename: M
authors.initials: M
authors.lastname: Matsuki
authors.forename: M
authors.initials: M
authors.lastname: Matsuo
mesh_terms: D000293:Adolescent; D001011:Aorta; D002648:Child; D002908:Chronic Disease; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior; D012082:Renal Veins; D012720:Severity of Illness Index; D014652:Vascular Diseases / Q000150:complications