A 41-year-old man with polyarthritis and severe autonomic neuropathy

Autor: Matthew E Bourcier, Aaron I Vinik
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Zdroj: Therapeutics and Clinical Risk Management, Vol 2008, Iss Issue 4, Pp 837-842 (2008)
Druh dokumentu: article
ISSN: 1176-6336
1178-203X
Popis: Matthew E Bourcier, Aaron I VinikEastern Virginia Medical School, Norfolk, VA, USAAbstract: Orthostasis due to autonomic neuropathy can cause severe debilitation and prove refractory to treatment. This report describes a case of severe sympathetic and parasympathetic autonomic dysfunction as a consequence of acetylcholine receptor antibodies and Sjogren’s syndrome. Symptomatic management, plasma fluid expanders, and IVIG therapy failed to offer a salutary response to the condition. Etanercept therapy provided improvement of the orthostasis and autonomic function measured as high and low frequency respiratory effects on heart rate variability as well as enhancement of skin blood flow using Laser Doppler. It would be of considerable interest to determine the effectiveness of etanercept in other autoimmune neuropathies.Keywords: autonomic neuropathy, etanercept, IntraEpidermal Nerve Fibers (IENF), acetylcholine receptor antibodies, laser doppler skin blood flow, orthostasis
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