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Clinical Autonomic Research
Published in: Clinical Autonomic Research 1/2017

01-02-2017 | Case Report

Autoimmunity-associated autonomic failure with sympathetic denervation

Authors: David S. Goldstein, Courtney Holmes, Patti Sullivan, Vincenzo Donadio, Risa Isonaka, Elizabeth Zhong, Bobby Pourier, Steven Vernino, Irwin J. Kopin, Yehonatan Sharabi

Published in: Clinical Autonomic Research | Issue 1/2017

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Abstract

We report a case of autoimmunity-associated autonomic failure in a young adult woman who developed arthritis followed 3 years later by pandysautonomia. There was early recovery of parasympathetic functions but persistent neurogenic orthostatic hypotension from post-ganglionic sympathetic denervation. Clinical laboratory testing indicated variable amounts of sympathetic neuronal re-sprouting in the heart, kidneys, eyes, and body as a whole upon follow-up evaluation after 1.5 years.
Literature
1.
Appenzeller O, Kornfeld M (1973) Acute pandysautonomia. Clin and morphologic study. Arch Neurol 29:334–339CrossRefPubMed
2.
Goldstein DS, Holmes C, Dendi R, Li ST, Brentzel S, Vernino S (2002) Pandysautonomia associated with impaired ganglionic neurotransmission and circulating antibody to the neuronal nicotinic receptor. Clin Auton Res 12:281–285CrossRefPubMed
3.
Goldstein DS, Holmes C, Frank SM, Naqibuddin M, Dendi R, Snader S, Calkins H (2003) Sympathoadrenal imbalance before neurocardiogenic syncope. Am J Cardiol 91:53–58CrossRefPubMed
4.
Tohgi H, Sano M, Sasaki K, Suzuki H, Sato T, Iwasaki T, Satodate R (1989) Acute autonomic and sensory neuropathy: report of an autopsy case. Acta Neuropathol 77:659–663CrossRefPubMed
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Young RR, Asbury AK, Adams RD, Corbett JL (1969) Pure pan-dysautonomia with recovery. Trans Am Neurol Assoc 94:355–357PubMed
Metadata
Title
Autoimmunity-associated autonomic failure with sympathetic denervation
Authors
David S. Goldstein
Courtney Holmes
Patti Sullivan
Vincenzo Donadio
Risa Isonaka
Elizabeth Zhong
Bobby Pourier
Steven Vernino
Irwin J. Kopin
Yehonatan Sharabi
Publication date
01-02-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Autonomic Research / Issue 1/2017
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-016-0388-0

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