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Onverklaarde aanhoudende moeheidsklachten

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Tijdschrift voor kindergeneeskunde

Summary

Fatigue is a common complaint among pediatric patients, especially among adolescents. In most cases the cause of the complaints is unclear. Persistent fatigue, although less common, frequently causes great concern among patients and parents, particularly in the case of severe fatigue like in the chronic fatigue syndrome (cfs) or unexplicable ongoing fatigue (uof). After a thorough medical history and physical examination there is, to exclude somatic diseases, no need for more than a very limited set of laboratory investigations. Patients and parents attributions affect the course of the complaints strongly. Principles of treatment are: recognition of the complaints, causality obviousness and empathy. The causality obviousness is a vital dilemma however. A percentage uof patients will at the end develop a chronic fatigue syndrome.

samenvatting

Moeheid is een veel voorkomende klacht bij pediatrische patiënten, in het bijzonder bij adolescenten. In de meeste gevallen blijft de oorzaak van de klachten onduidelijk. Aanhoudende moeheid vormt een bron van zorg voor zowel de patiënt als de ouders, vooral in het geval van ernstige moeheid als het chronisch vermoeidheidssyndroom (cvs) of onverklaarde aanhoudende moeheidsklachten (oam). Deze klachten kunnen, zolang geen verklaring wordt gevonden, aanleiding zijn voor alsmaar voortdurend vervolgonderzoek. Echter, na een goed uitgevoerde anamnese en een algemeen lichamelijk onderzoek is slechts een zeer beperkt aanvullend onderzoek nodig om onderliggende somatische ziekten uit te sluiten. Attributies van de patiënt zelf en de ouders bepalen in belangrijke mate mede het verdere beloop van de klachten. Voor de behandeling gelden algemene behandelprincipes zoals: erkenning van de klachten, voldoende duidelijkheid over de oorzaak van de klachten en empathie met de patiënt. Voldoende duidelijkheid over de oorzaak van de onverklaarde klachten vormt hierbij een cruciaal dilemma. Een percentage van de oam-patiënten zal uiteindelijk een chronisch vermoeidheidssyndroom ontwikkelen.

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    R. J. Bakker

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R.J. Bakker, kinderarts, Antonius Ziekenhuis, Sneek.Correspondentieadres: Rob J. Bakker, Antonius Ziekenhuis, Postbus 20000, 8600 BA Sneek

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Bakker, R.J. Onverklaarde aanhoudende moeheidsklachten. KIND 73, 157–161 (2005). https://doi.org/10.1007/BF03061568

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