Introduction:
Chronic fatigue is common in patients with chronic liver disease,
particularly cholestatic, sometimes of a severity markedly out of
proportion to liver dysfunction. However systematic studies on this
debilitated symptom are rare.
Aim:
To study the distribution, severity and possible associations of
chronic fatigue in a cohort of patients with chronic liver disease
of various aetiologies. Methodology: In 30 patients with liver
cirrhosis (19 female, 11 male, age 25-68 yrs, Childs A=4, B=12,
C=14) of various aetiologies (PBC= 10, Alcohol= 8, viral= 3,
sclerosing cholangitis=3, autoimmune chronic active hepatitis= 2,
other= 4) the Bentall mental fatigue score was measured and
correlated with clinical and biochemical parameters of liver
disease. 30 normal controls of a similar age range had the Bentall
score measured.
Results:
Bentall score was 3.5±0.4 (mean±SEM) for controls.
26/30 (86.8%) of patients had a mental fatigue score >mean+2SEM
of controls; 11/30 patients scored >15, 5/30 between 10-15 and
10/30 between 5-9. No significant difference in the mean Bentall
score was found between males and females, across aetiologies or
with the severity of liver disease (Childs score) even after
correction for anaemia, age, body mass index (BMI) and renal
function. No correlation was found between Bentall score and liver
function tests, haemoglobin, prothrombin time or nutritional status
(BMI, albumin).
Conclusion:
Chronic fatigue results from an altered (probably centrally
mediated) homeostatic mechanism which is deranged independent of
the severity and aetiology of liver disease. This mechanism is
poorly understood and requires further study.
JN Plevris, JA Cossar"^({*})", MM
Dollinger, IAD Bouchier, RE O'Carroll (*), PC Hayes. Liver Research
Laboratories University Department of Medicine and Clinical
Psychology (*), The Royal Infirmary Edinburgh EH3
9YW