skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8830

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

Case report

(1848) Views  (736) Full article downloads

Authors: Matthew E Bourcier, Aaron I Vinik

Published Date September 2008 Volume 2008:4(4) Pages 837 - 842
DOI: http://dx.doi.org/10.2147/TCRM.S2712

Matthew E Bourcier, Aaron I Vinik

Eastern Virginia Medical School, Norfolk, VA, USA

Abstract: 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








Readers of this article also read:

Cost-effectiveness analysis of electrochemotherapy with the Cliniporator™ vs other methods for the control and treatment of cutaneous and subcutaneous tumors
Towards a new standard of perioperative fluid management
Moderate and severe plaque psoriasis: cost-of-illness study in Italy
Nonlinear analysis of the heartbeats in public patient ECGs using an automated PD2i algorithm for risk stratification of arrhythmic death
Efficacy of deoxyspergualine for antibody-mediated rejection and proteinuria after kidney transplantation
Double-blind, randomized trial comparing efficacy and safety of continuing olanzapine versus switching to quetiapine in overweight or obese patients with schizophrenia or schizoaffective disorder
Multidisciplinary approach to the treatment of invasive fungal infections in adult patients. Prophylaxis, empirical, preemptive or targeted therapy, which is the best in the different hosts?
The benefits and risks of testosterone replacement therapy: a review
A comparative study of the prevalence of hyperkalemia with the use of angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers
Atrial fibrillation and the use of oral bisphosphonates