Disturbed adrenal function in adolescents with chronic fatigue syndrome.
OBJECTIVE
To investigate adrenal function in children and adolescents with chronic fatigue syndrome (CFS) compared with age-matched controls.


METHODS
Case-control study of low dose (500 ng/m2) synacthen tests (LDST) in 23 adolescents with CFS and 17 age-matched controls. Serum cortisol concentrations were measured at 5-min intervals from 10 to 45 minutes. Peak serum cortisol concentration, time to peak, rise in cortisol and area under the curve (AUC) were derived.


RESULTS
Patients with CFS had significantly lower mean cortisol levels during the LDST (p <0.001), lower peak cortisol (p <0.025), reduced cortisol AUC (p <0.005) and longer time to peak cortisol (p <0.05). Abnormalities were seen in both sexes but were more pronounced in females. Unstimulated adrenal androgen and 17-hydroxyprogesterone concentrations were normal.


CONCLUSIONS
Adolescents with CFS have subtle alterations in adrenal function suggesting a reduction in central stimulation of the adrenal glands. The more pronounced effects in females may reflect differential central effects of stress on hypothalamic-pituitary-adrenal axis regulation between the sexes.
Segal
T Y
TY
University College London Hospitals, UK.
Hindmarsh
P C
PC
Viner
R M
RM
D000293:Adolescent; D000307:Adrenal Gland Diseases / Q000209:etiology*; D000311:Adrenal Glands / Q000502:physiology*; D016022:Case-Control Studies; D015673:Fatigue Syndrome, Chronic / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D008297:Male; D010913:Pituitary-Adrenal System / Q000502:physiology; D012737:Sex Factors
D006854:Hydrocortisone