Open AccessAssociation of fatigue with an acute phase response in sarcoidosis
Author(s) -
Drent M.,
Wirnsberger R.M.,
De Vries J,
Van DieijenVisser M.p,
Wouters E.F.M.,
Schols A.M.W.J.
Publication year - 1999
Publication title -
european respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.021
H-Index - 241
eISSN - 1399-3003
pISSN - 0903-1936
DOI - 10.1034/j.1399-3003.1999.13d03.x
Subject(s) - sarcoidosis , medicine , resting energy expenditure , pathophysiology , gastroenterology , angiotensin converting enzyme , c reactive protein , endocrinology , energy expenditure , inflammation , blood pressure
The pathophysiological explanation for fatigue, one of the most common symptoms in sarcoidosis, still has to be elucidated. It was hypothesized that the presence of fatigue is associated with an acute phase response in sarcoidosis. A cross‐sectional study was performed in 38 sarcoidosis patients. Resting energy expenditure (REE) was measured in the fasting state by indirect calorimetry using a ventilated hood and adjusted for fat‐free mass (FFM). Patients with fatigue (n=25) also suffered more frequently from other symptoms, such as exercise intolerance (p=0.01), the need for sleep (p=0.02) and weight loss (p=0.01), compared to those without fatigue (n=13). However, no relationship was found between fatigue and serum angiotensin‐converting enzyme (sACE) or lung function impairment. Patients with fatigue had higher levels of C‐reactive protein (CRP) (11.4±6.8 µg·mL ‐1 , p<0.0001) and REE adjusted for FFM (33.0±3.7 kcal·kg FFM ‐1 , p<0.003) compared to those without fatigue (3.2±2.2 mg·mL ‐1 ; 29.2±2.8 kcal·kg FFM ‐1 ). Furthermore, REE/FFM was significantly related to CRP (r=0.54, p=0.001). This study confirms the presence of an acute phase response as indicated by metabolic derangements and a moderate increase in C‐reactive protein levels in sarcoidosis, particularly in those patients with constitutional symptoms. Future studies should focus on the clinical relevance and therapeutic implications of these findings.