Volgens een posterpresentatie van dr. Coucke

op het 15e Europese Congres voor Endocrinologie (27 april-1 mei)

werd in een groep van een kleine 500 ME/CVS- en/of fibromyalgiepatiënten

bij ca.10% afwijkingen in de hypofyse (cysten, adenomen en "lege cellen") geconstateerd.

Vaak gingen die abnormaliteiten gepaard met (te) lage concentraties groeihormoon,

met als mogelijk gevolg tekorten aan IGF-1, en ACTH- cortisol (stresshormonen).

meer informatie: http://en.wikipedia.org/wiki/Pituitary_gland

Morphologial and functional abnormalities of the hypofyse

in patients with diagnose of CFS or fibromyalgia. '

An example of misdiagnosis by Belgian chronic fatigue centres.

Endocrine Abstracts. 2013; 32: P222. doi:10.1530/endoabs.32.P222.

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

15th European Congress of Endocrinology

Copenhagen, Denmark, 27 April 2013 - 01 May 2013, European Society of Endocrinology

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 deficiency

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.

http://www.endocrine-abstracts.org/ea/0032/ea0032p222.htm

Met dank aan Manja.