title: Sympathetic neural hyperalgesia edema syndrome, a frequent cause of pelvic pain in women, mistaken for Lyme disease with chronic fatigue.
abstract: OBJECTIVE
  To show that chronic fatigue syndrome can be mistakenly attributed to Lyme disease rather than considering sympathetic neural hyperalgesia edema syndrome. This common disorder of women, frequently, but not always causing pelvic pain, can present simply as chronic fatigue.
  
  
  METHODS
  A water load test was performed in a woman reactive for B-Burgdorferi with chronic fatigue whose symptoms did not improve despite three months of treatment with doxycycline. A water load test was performed.
  
  
  RESULTS
  She failed the water load test by excreting only 50% ingested load standing for four hours. She showed marked improvement following treatment with dextroamphetamine sulfate.
  
  
  CONCLUSIONS
  This very treatable disorder of the sympathetic nervous system should be considered in women with an unknown cause of chronic fatigue or if the symptoms persist despite treatment of another potential cause.
authors.affiliation: The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden Cooper Hospital/University Medical Center, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ, USA. laurie@ccivf.com
authors.forename: J H
authors.initials: JH
authors.lastname: Check
authors.forename: R
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D003913:Dextroamphetamine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D015673:Fatigue Syndrome, Chronic / Q000209:etiology; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008193:Lyme Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D017699:Pelvic Pain / Q000209:etiology
chemical_list: D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine