Friday, 23 March 2012

Sarcoidosis associated fatigue


  1. Jolanda De Vries
-Author Affiliations
  1. *Faculty of Health, Medicine and Life Science, UNS 40 room 4.550, University Maastricht, PO Box 3100, 6202 NC Maastricht, The Netherlands
  2. #University of Cincinnati, Oncology Hematology Care, Inc., Cincinnati, OH USA 45220
  3. CoRPS, Dept of Medical Psychology, Room P510, Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
  1. Marjolein Drent, University Maastricht, Maastricht, Netherlands, E-mail:m.drent@hetnet.nl

Abstract

Sarcoidosis associated fatigue is globally recognized as a disabling symptom. Fatigue has been reported in up to 50–70% of sarcoidosis patients, causing impaired quality of life. The etiology of this troublesome problem remains elusive and is usually multifactorial. Fatigue can be a consequence of treatment itself, including the complications of corticosteroid therapy. 
The diagnosis of sarcoidosis associated fatigue requires an extensive evaluation to identify and treat potentially reversible causes. Granuloma formation and cytokine release may be involved in its etiology. However, despite adequate sarcoidosis treatment, many patients continue to experience fatigue. 
Co-morbidities associated with sarcoidosis, including depression, anxiety, hypothyroidism, and altered sleep patterns, may all contribute to fatigue. 
Despite an exhaustive search for treatable clinical causes of fatigue, most patients' complaints of fatigue are not correlated with clinical parameters of disease activity. Recent studies have demonstrated the effectiveness of various neurostimulants, including methylphenidate, for the treatment of sarcoidosis-associated fatigue. These and other agents may be useful adjuncts for the treatment of sarcoidosis associated fatigue. 
Obviously, there is a need for studies evaluating the causes and new therapeutics options of sarcoidosis-associated fatigue. Psychological interventions should also be examined.

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