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Outcome of 48 pediatric patients with chronic fatigue. A clinical experience
H M Feder1, P H Dworkin, C Orkin
1Department of Pediatrics, University of Connecticut Health Center, Farmington.
Insights
Pediatric chronic fatigue often resolves with simple encouragement, with most young patients experiencing symptom improvement or resolution. A structured approach to management is recommended for better outcomes in children with unexplained fatigue.
Area of Science:
- Pediatric Medicine
- Chronic Fatigue Syndromes
- Clinical Outcomes
Background:
- Chronic fatigue is a significant concern in pediatric patients.
- Identifying the cause of fatigue in children can be challenging.
- Previous studies have explored various diagnostic and therapeutic approaches.
Purpose of the Study:
- To define the outcomes of pediatric patients diagnosed with chronic fatigue.
- To evaluate the effectiveness of a structured management approach.
- To identify factors associated with prognosis in pediatric chronic fatigue.
Main Methods:
- A cohort study was conducted with a mean follow-up of 3.8 years.
- Patients aged 21 years and younger with unexplained fatigue lasting at least 3 months were included.
- Outcomes were determined through follow-up assessments, including telephone contact.
Main Results:
- Only one of 55 patients had an organic cause (sinusitis) for fatigue.
- At follow-up, 65% of patients reported symptom resolution, and 29% reported improvement.
- Laboratory studies were generally unhelpful in diagnosing the cause of fatigue.
Conclusions:
- Pediatric chronic fatigue often has a favorable prognosis with supportive management.
- Diagnostic and therapeutic interventions should be guided by positive findings.
- A structured approach to managing pediatric chronic fatigue is suggested.
Objective:
To define outcomes of pediatric patients with chronic fatigue.
Design:
Cohort study with a mean follow-up of 3.8 years.
Setting:
Outpatient pediatrics department at a university health center.
Patients:
Patients 21 years old and younger referred by their private physicians for evaluation of unexplained fatigue lasting at least 3 months.
Intervention:
Patients were seen from January 1986 through April 1990 and were telephoned in April 1992 to determine outcome.
Results:
Of the 55 patients who were evaluated from 1986 to 1990, an organic cause of the fatigue, sinusitis, was found for one. Of the 54 patients with unexplained fatigue, 48 were contacted in 1992. The mean age of these 48 patients was 15 years; 73% were female. Fatigue was present a mean of 7 months before evaluation, and in 78% an acute illness preceded the fatigue. Most patients believed their fatigue had an organic cause. In general, laboratory studies were not helpful. All patients were encouraged to resume normal functioning despite their symptoms. At follow-up, 65% reported resolution of symptoms, 29% reported improvement, and 6% were unchanged.
Conclusions:
In pediatric patients with chronic fatigue, diagnostic and therapeutic interventions should be based on positive findings; with simple encouragement, the prognosis is excellent. Based on this experience, we suggest a structured approach to the management of pediatric patients with chronic fatigue.
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