Indeed, a growing literature indicates that fatigue is common in most autoimmune-related diseases, as well as among individuals with related immunodeficiency disorders ( 7– 12). Over two-thirds of respondents reported that their fatigue was profound, debilitating, and prevented them from completing simple everyday tasks. A recent self-reported survey of individuals with autoimmune and related disorders by the American Autoimmune and Related Disorders Association indicated that this population's primary concern is fatigue ( 6).
Currently, there are over 100 recognized autoimmune diseases ( 3), and the prevalence of many autoimmune diseases continues to rise ( 4, 5). This review describes how inflammation and the central nervous system contribute to fatigue and suggests potential mechanisms involved in fatigue that are likely exhibited in autoimmune and related diseases.Īccording to the National Institutes of Health, autoimmune diseases are estimated to afflict over 20 million individuals in the United States ( 1, 2). Additionally, an important contributing element to fatigue is the central nervous system-a region impacted either directly or indirectly in numerous autoimmune and related disorders. Nevertheless, physiological processes known to play a role in fatigue include oxygen/nutrient supply, metabolism, mood, motivation, and sleepiness-all which are affected by inflammation. The exact mechanisms of fatigue are not well-understood, perhaps due to its broad definition. The severity and duration of fatigue episodes vary, but fatigue can cause difficulty for even simple tasks like climbing stairs or crossing the room. In general, fatigue is defined by debilitating periods of exhaustion that interfere with normal activities. Fatigue is multi-faceted and broadly defined, which makes understanding the cause of its manifestations especially difficult in conditions with diverse pathology including autoimmune diseases.
Profound and debilitating fatigue is the most common complaint reported among individuals with autoimmune disease, such as systemic lupus erythematosus, multiple sclerosis, type 1 diabetes, celiac disease, chronic fatigue syndrome, and rheumatoid arthritis. 5Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.4Department of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA, United States.3Department of Medicine, Harvard Medical School, Boston, MA, United States.2Department of Psychiatry, Harvard Medical School, Boston, MA, United States.1Veterans Affairs Boston Healthcare System, Boston, MA, United States.
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