title: Fatigue in patients with systemic lupus erythematosus: lack of associations to serum cytokines, antiphospholipid antibodies, or other disease characteristics.
abstract: OBJECTIVE
  To determine if fatigue in patients with systemic lupus erythematosus (SLE) is associated with levels of serum cytokines, antiphospholipid antibodies (aPL), or other disease features.
  
  
  METHODS
  In a cross sectional study 57 Caucasian patients with SLE were subjected to clinical neurological examination and cerebral magnetic resonance imaging (MRI). Fatigue was evaluated by Fatigue Severity Scale (FSS) and disease activity by SLE Disease Activity Index (SLEDAI). Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin 2 (IL-2), IL-6, IL-10, transforming growth factor-beta (TGF-beta), interferon-alpha (IFN-alpha), anticardiolipin antibody (aCL) IgG and IgM, as well as anti-beta2-glycoprotein I antibody (anti-beta2-GPI) IgG and IgM were analyzed by ELISA.
  
  
  RESULTS
  Four of 5 patients with SLE had fatigue (FSS score > or = 3). There were no associations between fatigue and any sociodemographic variables, medication for SLE, disease activity, cerebral infarcts, serum cytokines, aCL or beta2-GPI antibodies, or any routine hematological, biochemical, or immunological tests.
  
  
  CONCLUSIONS
  Fatigue is a common phenomenon in patients with SLE. There is no association to disease activity or other markers of disease or inflammation. Fatigue is a complex phenomenon, and cytokine involvement in brain tissue not reflected by cytokine serum concentrations in this study cannot be excluded. Alternatively, psychosocial factors may well be the dominant predictor of fatigue in patients with SLE.
authors.affiliation: Department of Clinical Medicine/Neurology, University of Tromsø, Norway. romdal@online.no
authors.forename: Roald
authors.initials: R
authors.lastname: Omdal
authors.forename: Svein Ivar
authors.initials: SI
authors.lastname: Mellgren
authors.forename: Wenche
authors.initials: W
authors.lastname: Koldingsnes
authors.forename: Eva A
authors.initials: EA
authors.lastname: Jacobsen
authors.forename: Gunnar
authors.initials: G
authors.lastname: Husby
mesh_terms: D000328:Adult; D000368:Aged; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D005221:Fatigue / Q000209:etiology / Q000276:immunology*; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D007376:Interleukin-2 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016212:Transforming Growth Factor beta / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D017152:Antibodies, Antiphospholipid; D016207:Cytokines; D016898:Interferon-alpha; D007376:Interleukin-2; D015850:Interleukin-6; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10