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Late-Onset Hypogonadism in a Male Patient with Long COVID Diagnosed by Exclusion of ME/CFS, 2022, Soejima et al

Discussion in 'Long Covid research' started by Andy, Apr 24, 2022.

  1. Andy

    Andy Committee Member

    Messages:
    16,725
    Location:
    Hampshire, UK
    Abstract

    After the acute phase of COVID-19, some patients have been reported to have persistent symptoms including general fatigue. We have established a COVID-19 aftercare clinic (CAC) to provide care for an increasing number of these patients.

    Here, we report the case of a 36-year-old man who developed post-COVID fatigue after acute infection with SARS-CoV-2. In the acute phase of COVID-19, the patient’s fever resolved within four days; however, general fatigue persisted for three months, and he visited our CAC 99 days after the initial infection. Examination revealed a high Aging Male’s Symptoms (AMS) score of 44 and low free testosterone (FT) level of 5.5 pg/mL, which meet the Japanese criteria of late-onset hypogonadism (LOH) syndrome. Imaging studies revealed an atrophic pituitary in addition to fatty liver and low bone mineral density. Anterior pituitary function tests showed a low follicle-stimulating hormonelevel and delayed reaction of luteinizing hormone (LH) after gonadotropin-releasing hormone (GnRH) stimulation, indicating the possibility of hypothalamic hypogonadism in addition to primary hypogonadism seen in patients with post-COVID-19 conditions. After the initiation of Japanese traditional medicine (Kampo medicine: hochuekkito followed by juzentaihoto), the patient’s symptoms as well as his AMS score and serum FT level were noticeably improved. Furthermore, follow-up tests of GnRH stimulation revealed improvements in LH responsiveness.

    Although many patients have been reported to meet the criteria of ME/CFS such as our case, we emphasize the possibility of other underlying pathologies including LOH syndrome. In conclusion, LOH syndrome should be considered a cause of general fatigue in patients with post-COVID-19 conditions and herbal treatment might be effective for long COVID symptoms due to LOH.

    Open access, https://www.mdpi.com/1648-9144/58/4/536/htm
     
    FMMM1, nick2155, sebaaa and 4 others like this.
  2. CRG

    CRG Senior Member (Voting Rights)

    Messages:
    819
    Location:
    UK
  3. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

    Messages:
    4,936
    Location:
    UK
    What are the chances that the patient already had or was developing these symptoms before Covid?

    I think there is a possibility that there will end up being two camps of researchers : 1) One group determined to exclude ME/CFS so that the sufferers can be experimented on freely and 2) Those determined to diagnose ME/CFS for political reasons.
     
    Trish likes this.

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