Fatigue is Common and Predicted by Female Gender and Sleep Disturbance in Patients with Chronic Spontaneous Urticaria

Background: Fatigue is a common and disabling symptom in chronic inflammatory diseases. To the best of our knowledge, there are no studies evaluating fatigue thoroughly in patients with CSU.

Objectives: To evaluate fatigue, its drivers in patients with CSU, and to compare patients to healthy controls in terms of fatigue.

Methods: One hundred and three patients with CSU and 35 age and gender matched healthy control subjects were evaluated for fatigue with the Fatigue Severity Scale and VAS-Fatigue. Patients were also assessed for their duration, activity, and control of disease, as well as anxiety, depression, and quality-of-life.

Results: There were no significant associations between disease activity, disease control scores, and FSS (p>0.05). Although there were no significant differences in terms of ANA positivity and IgE levels between fatigued and non-fatigued patients with CSU, CRP levels were higher in fatigued patients (p=0.009). A significant correlation was noted between total FSS score and Chronic Urticaria-QoL (r=0.246, p=0.013), DLQI (r=0.302, p=0.002) in patients with CSU. In regression analyses, female gender and presence of disturbed sleep were found to be significant predictors of fatigue in patients with CSU (p=0.008; odds ratio [OR]: 9.02, and p=0.001; OR: 8.35).

Conclusion: Fatigue is a common and important symptom in patients with CSU and adversely affects QoL. While evaluating patients with CSU, it is important to assess fatigue, especially in those female gender patients and in those having sleep disturbance.

Keywords: Chronic spontaneous urticaria; fatigue; quality of life.