Acute autonomic, sensory and motor neuropathy: successful treatment with IVIg

Intern Med. 2009;48(10):843-6. doi: 10.2169/internalmedicine.48.1848. Epub 2009 May 15.

Abstract

Acute autonomic, sensory and motor neuropathy (AASMN) is a rare peripheral nerve disorder characterized by prominent dysautonomia with somatic sensory and motor impairment. Dysautonomia in AASMN is intractable even with corticosteroid therapy or plasmapheresis. Here we report a case of AASMN with severe orthostatic hypotension. Although the effectiveness of corticosteroid was insufficient, high dose intravenous immunoglobulin therapy (IVIg) was effective for not only sensorimotor symptoms but also autonomic symptoms. This is the first case of AASMN showing favorable responses to IVIg treatment, suggesting that IVIg should be considered when corticosteroid therapy or plasmapheresis is ineffective or insufficient.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Autonomic Nervous System Diseases / diagnosis
  • Autonomic Nervous System Diseases / physiopathology
  • Autonomic Nervous System Diseases / therapy*
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Middle Aged
  • Norepinephrine / blood
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / physiopathology
  • Peripheral Nervous System Diseases / therapy*
  • Renin / blood
  • Shy-Drager Syndrome / diagnosis
  • Shy-Drager Syndrome / physiopathology
  • Shy-Drager Syndrome / therapy
  • Tilt-Table Test

Substances

  • Immunoglobulins, Intravenous
  • Renin
  • Norepinephrine