title: Hormonal and cardiovascular reflex assessment in a female patient with pure autonomic failure.
abstract: We report the case of a 72-year-old female with pure autonomic failure, a rare entity, whose diagnosis of autonomic dysfunction was determined with a series of complementary tests. For approximately 2 years, the patient has been experiencing dizziness and a tendency to fall, a significant weight loss, generalized weakness, dysphagia, intestinal constipation, blurred vision, dry mouth, and changes in her voice. She underwent clinical assessment and laboratory tests (biochemical tests, chest X-ray, digestive endoscopy, colonoscopy, chest computed tomography, abdomen and pelvis computed tomography, abdominal ultrasound, and ambulatory blood pressure monitoring). Measurements of catecholamine and plasmatic renin activity were performed at rest and after physical exercise. Finally the patient underwent physiological and pharmacological autonomic tests that better diagnosed dysautonomia.
authors.affiliation: Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: H F
authors.initials: HF
authors.lastname: Lopes
authors.forename: F M
authors.initials: FM
authors.lastname: Consolim-Colombo
authors.forename: D
authors.initials: D
authors.lastname: Hachul
authors.forename: M E
authors.initials: ME
authors.lastname: Carvalho
authors.forename: F
authors.initials: F
authors.lastname: Pileggi
authors.forename: H B
authors.initials: HB
authors.lastname: Silva
mesh_terms: D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology; D001919:Bradycardia / Q000503:physiopathology; D004244:Dizziness / Q000209:etiology; D005260:Female; D006334:Heart Function Tests; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007024:Hypotension, Orthostatic / Q000503:physiopathology; D012021:Reflex, Abnormal / Q000502:physiology; D013610:Tachycardia / Q000503:physiopathology; D018667:Tilt-Table Test