Small adrenal glands in Chronic Fatigue Syndrome (CFS): a preliminary computer tomography

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No inclusive or satisfactory biomedical explanation for

chronic fatigue syndrome (CFS) has as yet been forwarded.

Recent research suggests that a dysregulated

hypothalamic-pituitary-adrenal axis (HPA) may be contributory,

and in particular that there may be diminished forward drive

and adrenal under-stimulation. In this preliminary study we

wished to examine a cohort of CFS patients in whom evidence

for such hypofunctioning was found. Our aim was to establish

whether these patients had altered adrenal gland size.

Patients were recruited from a fatigue clinic. Those who

fulfilled the Centre for Disease Control and Prevention (CDC)

criteria underwent a 1 microgram adrenocorticotropin (ACTH)

stimulation test, a test of adrenal gland functioning.


subjects (five females, three males) with a subnormal response

to this test underwent a computer tomography (CT) adrenal

gland assessment. Measurements were compared with those from a

group of 55 healthy subjects. The right and left adrenal gland

bodies were reduced by over 50% in the CFS subjects indicative

of significant adrenal atrophy in a group of CFS patients with

abnormal endocrine parameters. This is the first study to use

imaging methods to measure adrenal gland size in CFS. It is a

limitation of this study that a selected CFS sample was

employed. A future larger study would optimally employ an

unselected cohort of CFS patients.

This study has implications

not only for the elucidation of CFS pathophysiology, but also

for possible therapeutic strategies.

Scott LV, Teh J, Reznek R, Martin A, Sohaib A, Dinan TG

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