Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2013) 32 P222 | DOI: 10.1530/endoabs.32.P222

Clinical case reports – Pituitary/Adrenal

Morphologial and functional abnormalities of the hypofyse in patients with diagnose of CFS or fibromyalgia. An example of misdiagnosis by Belgian chronic fatigue centres

Francis Coucke, Heidi Lammens, Laurens Coucke & Anne-Birgitte Vogter


METARES, Sint Gillis Was, Belgium.

Aim: In consultation, we check a lot of patients who present with diagnose of FM (fibromyalgia) and chronic fatigue syndrome (CFS). Most of these patients have a underlying diagnosis that causes chronic pain or fatigue. These causes are pathologies not easily detected.

Endocrine failure is one of the candidates, with hypofyse dysfunction as a possible candidate.

Methods: During 1 year: from October 11, 487 patients presented at the consultation we found 47 cases of morphological and functional hypofyse abnormalities. By examining with stress test in patients with clinical complaints and low basal hormones: e.g. low IGF1 or cortisol, combined with morphological abnormalities of the hypofyse.

Results: Forty seven patients with abnormalities of the hypofyse:

• Cystes: 6 cases average age 50.8, all female, mean diameter 5.2 mm (from 4 to 8 mm). All are ACTH–cortisol deficient and 1 of them is GH deficient (GHD).

• Adenomas: 31 cases average age: 42 years, 23 female, 8 males, mean size of 5 mm (from 12 to 3 mm), all are ACTH–cortisol deficient and 11 are also GHD.

• Empty cells: 12 cases: average age: 53, 25 years, 5 males, 7 females, all deficient in ACTH–cortisol and 8 are GHD.

Conclusion: Patients with a diagnose of CFS or fibromyalgia should always be checked for underlying chronic diseases. Mostly immunologic but also endocrine diseases can be underlying. E.g. frequently adrenal insufficiency can be detected. A lot of reports document also a low IGF1 and GHD.

Patients with hormone deficiencie should also be checked for other hormone deficiencies. In case of low hypofyse hormones, single or multiple, the hypofyse has to be functionally and morphologically checked. On contrary with the disappointing general therapy of FM or CFS, a good and efficient therapy can be offered to patients by treating the underlying hormonal deficiencies.

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