title: [Pure autonomic failure].
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.
authors.affiliation: Serviço de Medicina III, Hospital de Santa Maria, Lisboa.
authors.forename: J L
authors.initials: JL
authors.lastname: Ducla-Soares
authors.forename: A S
authors.initials: AS
authors.lastname: Guerreiro
authors.forename: P
authors.initials: P
authors.lastname: Póvoa
authors.forename: E
authors.initials: E
authors.lastname: Alvares
authors.forename: L
authors.initials: L
authors.lastname: Guerreiro
authors.forename: F
authors.initials: F
authors.lastname: Carrilho
authors.forename: M
authors.initials: M
authors.lastname: Santos
authors.forename: J
authors.initials: J
authors.lastname: Figueirinhas
authors.forename: M
authors.initials: M
authors.lastname: Carvalho
mesh_terms: 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
chemical_list: D008787:Metoclopramide; D005438:Fludrocortisone; D009638:Norepinephrine
vernacular_title: Falência autonómica pura.