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Fatigue is not a specific symptom in patients with primary biliary cirrhosis

Björnsson, Einara; Simren, Magnusa; Olsson, Rolfa; Chapman, Roger W.b

European Journal of Gastroenterology & Hepatology: March 2005 - Volume 17 - Issue 3 - p 351-357
Original Articles: Primary Billary Cirrhosis
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Background Fatigue has been reported to be common in patients with primary biliary cirrhosis (PBC). Limited data exist on comparison with fatigue in the general population and comparison with patients with other chronic gastrointestinal disorders are lacking.

Method We enrolled 96 patients with PBC (87 females); mean age 63 (range 34–65) who completed the Fatigue Impact Scale (FIS). In comparison we included matched controls from the general population, patients with organic (OGD) and functional GI disorders (FGD). Liver function test and the latest liver biopsy were analysed and correlated with fatigue scores.

Results The mean duration of PBC was 7.4 years, the mean bilirubin 13 μmol/l. Twelve per cent of patients had cirrhosis, 29% were in stage I on Ludwig's histology score and 30% and 29% were in stages II and III, respectively. The PBC patients had a median FIS total score of 29 in comparison with 38 in GP controls (P<0.05). Patients with OGD and FGD had more severe fatigue (FIS total score 67 and 59 (P<0.01 compared with PBC)). Fatigue in the PBC patients did not correlate with liver tests and histology stage.

Conclusion PBC patients had less severe fatigue measured with the FIS than controls from the GP and patients with OGD and FGD. This study also confirms results of other studies showing no correlation with fatigue in PBC and liver disease parameters. These results argues strongly against fatigue as a specific symptom in PBC.

aDepartment of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg Sweden

bJohn Radcliffe Hospital, Oxford, UK

This study was supported by the Faculty of Medicine, University of Gothenburg.

Correspondence to Dr Einar Björnsson, Department of Internal Medicine, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden

Tel: +46 313 421000; fax: +46 318 22152;

e-mail: einar.bjornsson@medic.gu.se

Received 19 April 2004 Revised 28 October 2004 Accepted 12 November 2004

© 2005 Lippincott Williams & Wilkins, Inc.