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CLINICAL, PHYSIOLOGICAL AND PATHOLOGICAL OBSERVATIONS IN A CASE OF PROGRESSIVE AUTONOMIC NERVOUS SYSTEM DEGENERATION ASSOCIATED WITH HOLMES‐ADIE SYNDROME AND PERIPHERAL NEUROPATHY
Author(s) -
FREWIN D. B.,
GILMORE H. R.,
HO J. Q. K.,
SCROOP G. C.
Publication year - 1968
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1968.17.2.141
Subject(s) - pathological , medicine , autonomic nervous system , autopsy , peripheral , degeneration (medical) , peripheral neuropathy , peripheral nervous system , anesthesia , central nervous system , surgery , pathology , heart rate , blood pressure , endocrinology , diabetes mellitus
Summary The case history is reported of a woman aged 40 years who presented with weight loss, postural hypotension and paræsthesia in the hands and feet. The diagnosis of widespread autonomic nervous system degeneration with associated peripheral neuropathy and Holmes‐Adie syndrome was made from the results of a series of clinical and physiological tests. Laboratory investigation failed to disclose a cause for the degenerative changes, and symptomatic treatment with 9‐alpha fluorohydrocortisone and digitalis was commenced in an effort to combat the patient's postural hypotension. On this régime there was transient improvement in her clinical state, but over a period of six months her general condition gradually deteriorated and she eventually died. At autopsy, widespread amyloid infiltration of the sympathetic ganglia, peripheral nerves, heart and alimentary canal was found, and this appears to have been the pathological basis for the clinical and physiological findings.