Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—In his discussion about
chronic fatigue syndrome (CFS), Dr Komaroff1
states that, in addition to symptoms included in the case definition, many
patients with CFS also frequently report anorexia, nausea, and dizziness.
Counting these latter symptoms, which have also been found in adrenal insufficiency,2 CFS shares 23 features with Addison disease,3 including both the symptoms of the case definition
for CFS and all the neuropsychological complaints that have led some people
to claim that CFS is just a manifestation of an underlying depression. Considering
that no medical condition except Addison disease shares more than 20 features
with CFS, it is unclear why no study to my knowledge has been performed to
determine whether the treatment for Addison disease, ie, hydrocortisone plus
fludrocortisone acetate, could also benefit CFS patients. Fludrocortisone
is likely to be of benefit based on a previous study in patients with CFS.4
Baschetti R. Chronic Fatigue Syndrome. JAMA. 1998;279(6):431–433. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-6-jac81007
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