Fatigue 2018-01-30T16:38:19+08:00

Differential diagnosis

  • Infection
    • Tuberculosis
    • Human immunodeficiency virus
    • Infective endocarditis
    • Post-viral fatigue syndrome
  • Neoplastic
    • Lung – cough, haemoptysis
    • Gastrointestinal – change in bowel habit, weight loss, PR bleeding
    • Breast – breast lumps, nipple discharge, skin changes
    • Prostate – dysuria, haematuria, terminal dribbling
    • Hepatocellular carcinoma – jaundice, itching, symptomatic ascites
  • Symptomatic anaemia
    • Microcytic: chronic blood loss, iron deficiency, thalassaemia
    • Normocytic: anaemia of chronic disease, malabsorption, chronic haemolysis
    • Macrocytic: alcohol, pregnancy, thyroid dysfunction, myelodysplastic syndrome
  • Inflammatory
    • Systemic lupus erythematosus
    • Rheumatoid arthritis
    • Polymyalgia rheumatica
    • Primary biliary cirrhosis
  • Endocrine
    • Diabetes mellitus
    • Hypothyroidism
    • Adrenal insufficiency
      • Primary
      • Tuberculous
      • Bilateral adrenalectomy for Cushing’s
      • Exogenous steroid withdrawal, including TCM
  • Drugs
    • β blockers
    • Benzodiazepines
    • Alcohol
    • Anti-histamines
  • Metabolic
    • Obstructive sleep apnoea
    • Haemochromatosis
  • Degenerative / neurological
    • Alzheimer’s dementia
    • Myasthenia gravis
  • Failures
    • Congestive cardiac failure
    • Renal failure
    • Cirrhosis
  • Psychological
    • Chronic fatigue syndrome

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