Morton Adam, King David
Mater Adult Hospital, South Brisbane, Queensland.
Aust Fam Physician. 2003 Nov;32(11):895-900.
Most causes of fatigue are ill defined, self limiting or elude diagnosis. Many endocrine disorders present with nonspecific features including fatigue, so are difficult to differentiate on clinical grounds. However, avoiding diagnostic delay is vital to prevent significant morbidity and mortality. Thus, a high index of suspicion and knowledge of appropriate investigations is important. Endocrine disorders predispose the individual to developing related disorders; fatigue may be one sign of associated comorbidity.
This article discusses the endocrine disorders that commonly present with or develop fatigue as a prominent feature, with emphasis on particular challenges for diagnosis, investigation or management. Screening recommendations for comorbid disease was generated by an extensive review of current evidence.
The identification of endocrine disorders can be both challenging--due to patterns of presentation--and rewarding for doctors and patients alike, due to importance and effectiveness of treatment.
大多数疲劳的病因尚不明确，呈自限性或难以诊断。许多内分泌疾病表现为包括疲劳在内的非特异性特征，因此难以根据临床症状进行鉴别。然而，避免诊断延迟对于预防严重的发病率和死亡率至关重要。因此，高度的怀疑指数和对适当检查的了解很重要。内分泌疾病使个体易患相关疾病；疲劳可能是合并症的一个迹象。
本文讨论通常以疲劳为突出特征出现或并发疲劳的内分泌疾病，重点关注诊断、检查或管理方面的特殊挑战。通过广泛回顾当前证据得出了合并疾病的筛查建议。
由于临床表现形式，内分泌疾病的识别可能具有挑战性，但由于治疗的重要性和有效性，对医生和患者来说都是有意义的。
