Fatigue in systemic lupus erythematosus

Ahn, Grace E.; Ramsey‐Goldman, Rosalind

doi:10.2217/ijr.12.4

Cited by 78 publications

(93 citation statements)

References 100 publications

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“…Almost every patient presented with fatigue, which is found in other studies as well. Fatigue is one of the most common, non specific, initial presentation of SLE, reported in literature 16. Joint pains ranged from arthralgia to intermittent polyarthritis.…”

Section: Discussionmentioning

confidence: 99%

Pattern of initial clinical manifestations of systemic lupus erythematosus in a tertiary care hospital

Batool¹,

Ahmad²,

Saeed³

et al. 2016

Pak J Med Sci

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Objective:To determine the pattern of initial clinical manifestations of Systemic Lupus Erythematosus (SLE) and to compare these features with those recorded elsewhere in PakistanMethods:This cross-sectional, descriptive study was performed in the Department of Rheumatology, Fatima Memorial Hospital, Lahore, Pakistan, from November 2015 to January 2016. Sixty one patients of SLE diagnosed as per ACR (American College of Rheumatology) 1982 revised criteria, were enrolled. The patients were evaluated for the initial clinical manifestations of SLE. The information was collected on a specially designed proforma and analyzed by using SPSS version 17.Results:Out of 61 patients, 49 (80.3%) were females and 12 (19.7%) males, showing a female to male ratio of 4:1. The mean age of patients was 26.2 ± 7.9 years. Fatigue was the most common presenting feature in 56 (91.8%) patients, followed by joint pains in 55 (90.2%) and fever in 54 (88.5%). Renal involvement was found in 46 (75.4%). Comparison of these presenting features was made with other studies carried out in Northern Pakistan (Islamabad) and in central Punjab (Pakistan). There were statistically significant differences in fever, fatigue and arthritis between our patients and the other two above mentioned study groups. However, comparison of renal manifestations showed significant difference only with Islamabad study, and not with previous study from central Punjab.Conclusion:In this study, majority of patients presented with combination of fatigue, fever, rash and arthritis. Almost three-fourth of patients had renal manifestations at initial presentation. Therefore, it is important for clinicians to have high index of suspicion for SLE, when patients present with above symptoms.

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Section: Discussionmentioning

confidence: 99%

Pattern of initial clinical manifestations of systemic lupus erythematosus in a tertiary care hospital

Batool¹,

Ahmad²,

Saeed³

et al. 2016

Pak J Med Sci

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“…6 Fatigue in SLE is likely multifactorial and caused by disordered sleep, anxiety and depression, pain, polypharmacy, comorbidities, and possibly disease activity. 8 …”

Section: Introductionmentioning

confidence: 99%

Fatigue, patient reported outcomes, and objective measurement of physical activity in systemic lupus erythematosus

Mahieu

Ahn

Chmiel

et al. 2016

Lupus

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Objective Fatigue is a common symptom in systemic lupus erythematosus (SLE), and engaging in physical activity (PA) may reduce fatigue. We aimed to characterize relationships between fatigue, other health status measures assessed with the Patient Reported Outcomes Measurement Information System (PROMIS) instruments, and accelerometer-based PA measurements in patients with SLE. The internal consistency of each PROMIS measure in our SLE sample was also evaluated. Methods This cross-sectional study analyzed 123 adults with SLE. The primary fatigue outcome was Fatigue Severity Scale (FSS) score. Secondary outcomes were Patient Reported Outcomes Measurement Information System (PROMIS) standardized T-scores in seven health status domains. Accelerometers were worn for seven days, and mean daily minutes of light, moderate/vigorous, and bouted (10 minutes) moderate/vigorous PA were estimated. Cronbach’s alpha was determined for each PROMIS measure to assess internal consistency. Relationships between FSS, PROMIS, and PA were summarized with Spearman partial correlation coefficients (r), adjusted for average daily accelerometer wear time. Results Mean FSS (4.3, SD 1.6) was consistent with clinically relevant levels of fatigue. Greater daily and bouted moderate/vigorous PA minutes correlated with lower FSS (r=−0.20, p=0.03 and r=−0.30, p=0.0007, respectively). For PROMIS, bouted moderate/vigorous PA minutes correlated with less fatigue (r=−0.20, p=0.03). PROMIS internal consistency was excellent, with Cronbach’s alpha >0.90 for each domain. Mean PROMIS T-scores for fatigue, pain interference, anxiety, sleep disturbance, sleep-related impairment, and physical function were worse than reported for the general U.S. population. More moderate/vigorous PA minutes were associated with less pain interference (r=−0.22, p=0.01). Both light PA and moderate/vigorous PA minutes correlated with better physical function (r=0.19, p=0.04 and r=0.25, p=0.006, respectively). Conclusion More time spent in moderate/vigorous PA was associated with less fatigue (FSS and PROMIS), less pain interference, and better physical function (PROMIS). PROMIS had excellent internal consistency in our SLE sample, and six of seven PROMIS measures indicated poorer average health status in SLE patients compared to the general U.S. population.

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“…Accordingly, the US Centers for Disease Control reports of fibromyalgia coexisting 25-65% of the time in connection with other connective tissue diseases have been noted [12]. As discussed by Ahn and Goldman-Ramsey [13], there remain limitations in measurements of fatigue in SLE whereby research showed fatigue experienced in 53-80% of lupus patients and the pain/fatigue combination experienced in 95% of lupus patients. Given the significant impact of HyPOTS on the quality of life, these patients should be screened for hypermobility accordingly.…”

Section: Discussionmentioning

confidence: 99%

Joint Hypermobility Syndrome and Postural Orthostatic Tachycardia Syndrome (HyPOTS)

Mandel¹,

Askari²,

Malemud³

et al. 2017

Biomed Res Clin Prac

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Objective: To evaluate the association between joint hypermobility syndrome associated with postural orthostatic tachycardia syndrome (HyPOTS) and fibromyalgia. Methods:A chart review of patients followed at two outpatient Rheumatology facilities within one hospital system were analyzed. Thirty-seven patients (3 male, 34 female) diagnosed with HyPOTS and fibromyalgia were reviewed.Results: HyPOTS is a chronically disabling musculoskeletal disorder presenting clinically as widespread musculoskeletal pain and/or fatigue with joint hypermobility. However, HyPOTS may be inadvertently diagnosed as chronic fatigue syndrome or fibromyalgia. In fact, the group of fibromyalgia patients evaluated at a rheumatology outpatient clinic were found to meet the clinical criteria for HyPOTS. Conclusions:Patients diagnosed with fibromyalgia and chronic fatigue syndrome may benefit from a further evaluation for HyPOTS. Thus, if HyPOTS is properly defined, a wide range of therapeutic options for these patients become available in order to improve their physical manifestations and quality of life.

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Fatigue in systemic lupus erythematosus

Cited by 78 publications

References 100 publications

Pattern of initial clinical manifestations of systemic lupus erythematosus in a tertiary care hospital

Pattern of initial clinical manifestations of systemic lupus erythematosus in a tertiary care hospital

Fatigue, patient reported outcomes, and objective measurement of physical activity in systemic lupus erythematosus

Joint Hypermobility Syndrome and Postural Orthostatic Tachycardia Syndrome (HyPOTS)

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