Fatigue complicating chronic liver disease.
Fatigue is common and can be profound in patients with chronic liver diseases, such as primary biliary cirrhosis (PBC) and chronic hepatitis C. The pathogenesis of fatigue in such patients is unknown; it may be related to infection with the hepatitis C virus or the pathophysiology of cholestasis in PBC, to a psychological reaction to knowledge of the diagnosis, or to the presence of chronic liver disease. A major problem in evaluating a treatment for fatigue in a randomized controlled trial is the inherent subjectivity of fatigue and the lack of a satisfactory objective quantitative primary efficacy endpoint. Experimental studies in rats and male athletes have implicated the serotonin neurotransmitter system in fatigue of central origin. Administration of the 5-HT3 serotonin receptor subtype antagonist, ondansetron, has been associated with substantial sustained clinical ameliorations of profound fatigue in at least some patients with chronic liver disease.
Jones
E Anthony
EA
Department of Gastrointestinal and Liver Diseases, Academic Medical Center, 1105 AZ Amsterdam-ZO, The Netherlands. tjones@xs4all.nl
D000818:Animals; D002908:Chronic Disease; D005221:Fatigue / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology; D006526:Hepatitis C / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000503:physiopathology; D044406:Receptors, Serotonin, 5-HT3 / Q000378:metabolism; D012701:Serotonin / Q000378:metabolism; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists / Q000627:therapeutic use; D016896:Treatment Outcome
D044406:Receptors, Serotonin, 5-HT3; D058831:Serotonin 5-HT3 Receptor Antagonists; D012702:Serotonin Antagonists; D012701:Serotonin