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PubMed · 8140921

[Pure autonomic failure].

J L Ducla-Soares·A S Guerreiro·P Póvoa·E Alvares·L Guerreiro·F Carrilho·M Santos·J Figueirinhas·M Carvalho
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Abstract

We present the case of a 64-year-old woman who, in the past 5 years, complained of constipation/diarrhea, hyposudoresis, xerostomia and xerophthalmia, dysuria and orthostatic hypotension. Cardiovascular reflexes analysis revealed sympathetic and parasympathetic failure. Norepinephrine was markedly reduced, both lying and after tilt. Norepinephrine infusion determined a significant rise in blood pressure, allowing the diagnosis of denervation hypersensitivity. The diagnosis of pure autonomic failure was made. Therapy with 9 alpha fludrocortisone and metoclopramide was initiated with marked and sustained symptomatic effect.

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Autonomic Nervous System DiseasesChronic DiseaseDiagnosis, DifferentialDrug Therapy, CombinationFemaleFludrocortisoneHumansMetoclopramideMiddle AgedNorepinephrineCase ReportsEnglish AbstractJournal ArticleReview

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J L Ducla-Soares, A S Guerreiro, P Póvoa, E Alvares, L Guerreiro, F Carrilho, M Santos, J Figueirinhas, M Carvalho. 1993. [Pure autonomic failure].. https://pubmed.ncbi.nlm.nih.gov/8140921/

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PubMed2000

[Syndromes of autonomic dysfunction associated with orthostatic intolerance].

Stimulated by the wide-spread use of tilt table testing, disorders of autonomic function with orthostatic hypotension have recently gained attention by clinical cardiologists. At the same time, improved characterization of the underlying circulatory responses have led to a reclassification of these syndromes. In particular, three subgroups of chronic primary dysautonomia have been defined: pure autonomic dysfunction, multiple system atrophy, and the postural orthostatic tachycardia syndrome. On the other hand, acute dysautonomias represent a rare yet clinically sometimes dramatic form of autonomic disorders. Several diseases as well as enzymatic disorders, and pharmacological drugs may cause secondary dysautonomia. The clinical correlate of all these forms of dysautonomia is orthostatic hypotension and syncope. Thus, a careful history forms the basis of a successful diagnostic workup of the underlying cause of syncope. This review summarizes the current knowledge of autonomic disorders, their classification and diagnostic and therapeutic strategies.

Autonomic Nervous System Diseases↗