[Pure autonomic failure].
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.
Ducla-Soares
J L
JL
Serviço de Medicina III, Hospital de Santa Maria, Lisboa.
Guerreiro
A S
AS
Póvoa
P
P
Alvares
E
E
Guerreiro
L
L
Carrilho
F
F
Santos
M
M
Figueirinhas
J
J
Carvalho
M
M
D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000188:drug therapy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D005438:Fludrocortisone / Q000008:administration & dosage; D006801:Humans; D008787:Metoclopramide / Q000008:administration & dosage; D008875:Middle Aged; D009638:Norepinephrine
D008787:Metoclopramide; D005438:Fludrocortisone; D009638:Norepinephrine
Falência autonómica pura.