La sindrome da affaticamento cronicoè un’affezione caratterizzata da senso di faticadebilitantee da una varietà di disturbi associati. Poiché nella sua forma tipica compare improvvisamente in un soggetto precedentemente attivo, può indurre il paziente a ricercare cure urgenti in PS. Colpisce maggiormente il sesso femminile e l’età è compresa tra 25 e 45 anni.
Quali sono le cause della sindrome di affaticamento cronico?
Generalmente un banale processo flogistico simil-influenzale o qualche altro stress acuto lasciano il paziente in preda a uno stato di prostrazione. Nel corso degli anni sono stati proposti molteplici agenti patogeni (infezioni da EBV, malattia di Lyme, candidosi croniche ecc..) ma, sebbene sia probabile una correlazione tra infezioni virali e sindrome da affaticamento cronico, la patogenesi virale diretta non è ancora stata provata. Molteplici evidenze dimostrano una disregolazione del sistema immunitario ( riduzione degli immunocomplessi circolanti, cellule natural killer, ridotte o meno funzionanti, livelli alterati di IG ecc..) ma dati definitivi non sono ancora disponibili. È stata dimostrata inoltre un’associazione con disfunzioni metaboliche, una forma di depressione lievemente moderato è presente in circa i 2/3 dei pazienti, molti autori propongono che la SAC sia un disturbo essenzialmente psichiatrico.
Diagnosi
L’esame obiettivo e il test di laboratorio sono ovviamente necessari per escludere altre possibili cause dei sintomi manifestati dal paziente; il riscontro di alterazioni significative le pone fortemente a favore di altri processi patologici escludendo la sindrome da affaticamento cronico; quest’ultima non ha alcun elemento patognomonico e rimane una diagnosi di esclusione.
Trattamento
Il paziente dovrebbe essere informato sulla diagnosi e rassicurato della bontà della prognosi; utili sono i consigli mirati a correggere stili di vita inappropriati:essendo frequenti turbe del sonno, si devono sconsigliare il consumo di pasti serali abbondanti e l’assunzione di alcolici e caffeina; occorre incoraggiare un regime di esercizio fisico moderato. Molti sintomi della sindrome da affaticamento cronico rispondere a trattamenti sintomatici: i Fans alleviano le cefalee e il dolore diffuso da febbricola, gli antistaminici le riniti e le sinusiti allergiche. Gli antidepressivi ad azione non sedativa migliorano l’umore, riducono i disturbi del sonno attenuando in qualche misura la sensazione di affaticamento .
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