Nakazato Yoshihiko, Tamura Naotoshi, Yamamoto Toshimasa, Abe Tatsuya, Shimazu Kunio
Department of Neurology, Saitama Medical School, Saitama 350-0495, Japan.
Rinsho Shinkeigaku. 2002 Feb;42(2):171-4.
A 60-year-old man was admitted to our hospital because of heat intolerance induced by generalized anhidrosis. There were no abnormal findings on physical and neurological examinations except for anhidrosis. Reflex sweating to pilocarpine and acetylcholine was absent. Skin biopsy revealed no abnormalities of the sweat glands and ducts. Laboratory tests showed elevated levels of serum IgG and rheumatoid factor. Anti-nuclear antibodies, and antibodies to Sjögren's syndrome A and B were positive. Ocular examination revealed the presence of keratoconjunctivitis sicca. The pathological findings of minor salivary gland specimen confirmed a diagnosis of Sjögren's syndrome. This case suggests that generalized anhidrosis could be caused by the antigen-antibody reaction for the cholinergic receptor of sweat gland.
一名60岁男性因全身无汗引起的不耐热而入住我院。除无汗外，体格检查和神经检查均未发现异常。对毛果芸香碱和乙酰胆碱的反射性出汗缺失。皮肤活检显示汗腺和导管无异常。实验室检查显示血清IgG和类风湿因子水平升高。抗核抗体以及抗干燥综合征A和B抗体呈阳性。眼科检查发现有干眼症。小唾液腺标本的病理结果证实了干燥综合征的诊断。该病例提示全身无汗可能是由汗腺胆碱能受体的抗原抗体反应引起的。
