Chronic fatigue disorders: an inappropriate response to arginine vasopressin?

Chronic fatigue disorders are characterized by a subjectively

defined group of symptoms such as chronic fatigue, mental

confusion, exertional malaise, weight changes, and/or diffuse

multi-joint pains. Significant clinical overlap exists between

chronic fatigue disorders and the syndrome of serum

inappropriate anti-diuretic hormone (SIADH). Both chronic

fatigue disorders and SIADH are characterized by lethargy and

mental confusion. Both disorders can be induced or exacerbated

by viral illnesses, physical exertion, emotional stress and/or

hypotension. Both can be treated with salt loading and

glucocorticoids. Therefore, altered water metabolism resulting

from inappropriate release and/or response to arginine

vasopressin (AVP) is proposed as a pathophysiological basis of

certain chronic fatigue disorders. Moreover, these data

suggest that salt loading and/or direct inhibition of AVP may

be an effective therapeutic approach in individuals with

chronic fatigue disorders.

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