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September 23/30, 1998

The Nature of Chronic Fatigue

JAMA. 1998;280(12):1094-1095. doi:10.1001/jama.280.12.1094

Fatigue is a prominent accompaniment of a wide range of disorders, including acute or chronic infections, end-stage neoplasia, renal insufficiency, congestive heart failure, and some psychiatric illnesses. It has been speculated that the severe fatigue associated with neurocirculatory asthenia, termed irritable heart syndrome by Da Costa1 and soldier's heart by Lewis2 during World War I, were early descriptions of the symptoms of orthostatic hypotension.3 The common experience of severe fatigue after prolonged, exhausting physical labor or exercise and the muscular symptoms that sometimes accompany chronic fatigue syndrome (CFS) have stimulated research on the possible role of muscular disorders in its causation, but with unconvincing results. And, of course, a viral origin has been commonly considered to be a likely cause of chronic fatigue for many years.

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