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Does severe nutcracker phenomenon cause pediatric chronic fatigue?
1Department of Pediatrics, Tenri Hospital, Nara, Japan.
Insights
Nine children with chronic fatigue syndrome (CFS/CF) were found to have severe nutcracker phenomenon (NC). This condition was associated with autonomic dysfunction symptoms, suggesting a potential link in pediatric cases.
Area of Science:
- Pediatric Medicine
- Cardiology
- Nephrology
Background:
- Nine children with chronic fatigue were evaluated over five years.
- These children experienced intermittent or persistent school absenteeism.
- Initial suspicions included psychosomatic disorders and autonomic dysfunction.
Purpose of the Study:
- To investigate the underlying causes of chronic fatigue in children.
- To explore potential associations between physical conditions and chronic fatigue syndrome/idiopathic chronic fatigue (CFS/CF).
Main Methods:
- Children presenting with chronic fatigue and suspected autonomic dysfunction were assessed.
- Diagnostic investigations included evaluation for orthostatic proteinuria.
- Accidental discovery of severe nutcracker phenomenon (NC) during the diagnostic process.
Main Results:
- All nine children with chronic fatigue exhibited severe typical nutcracker phenomenon (NC).
- Orthostatic proteinuria was noted in some of the children.
- The children's symptoms met the diagnostic criteria for chronic fatigue syndrome or idiopathic chronic fatigue (CFS/CF).
Conclusions:
- A significant association exists between severe nutcracker phenomenon (NC) and autonomic dysfunction symptoms in children diagnosed with CFS/CF.
- Nutcracker phenomenon may be an underrecognized contributor to chronic fatigue and associated symptoms in pediatric populations.
Background:
In the past five years we experienced 9 fatigued disabled children who were intermittently or persistently absent from school.
Patients:
They had been suspected to be burdened with psychosomatic disorders, having orthostatic hypotension, postural tachycardia, or other autonomic dysfunction symptoms.
Results:
Investigating the cause of moderate orthostatic proteinuria in some of them, we found by chance severe typical nutcracker phenomenon (NC), which was present in all 9 children complaining of chronic fatigue.
Conclusion:
Their symptoms filled the criteria of chronic fatigue syndrome or idiopathic chronic fatigue (CFS/CF). An association between severe NC and autonomic dysfunction symptoms in children with CFS/CF has been presented.