Negaard Matthew, Anthony Christopher, Bonthius Daniel, Jepson Matthew, Marcussen Britt, Pelzer Daniel, Peterson Andrew
Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Department of Orthopedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
SAGE Open Med Case Rep. 2017 Aug 8;5:2050313X17721601. doi: 10.1177/2050313X17721601. eCollection 2017.
Hyperhidrosis can cause dehydration and exercise intolerance. There are several case reports of extremely high sweat rates in athletes. We present as case report of a 17-year-old male with the highest sweat rate recorded in the literature (5.8 L/h). Our goal was to determine if glycopyrrolate, an anticholinergic medication with primarily anti-muscarinic effects that is known to decrease sweat production, would reduce the sweat rate of our subject in a controlled exercise setting.
Our patient and a control subject were subjected to an exercise protocol consisting of running on a treadmill (5.4-6.7 mile/h at 1° of incline) in a warm climate-controlled chamber after receiving 0, 2, or 4 mg of glycopyrrolate. Core temperature, heart rate, rater of perceived exertion, and sweat rate were monitored in both subjects.
Glycopyrrolate dose was not significantly correlated with decreased sweat rate and maximal core temperature. However, the clinical effect of reducing the sweat rate was very strong. The improvement of the subject's sweat rate allowed him to successfully return to sport.
Our findings suggest that low-dose glycopyrrolate may be a safe and effective method of controlling exertional hyperhidrosis.
多汗症可导致脱水和运动不耐受。有几例关于运动员出汗率极高的病例报告。我们报告一例17岁男性，其出汗率为文献记载中最高（5.8升/小时）。我们的目标是确定格隆溴铵（一种主要具有抗毒蕈碱作用的抗胆碱能药物，已知可减少汗液分泌）在可控运动环境下是否会降低该受试者的出汗率。
我们的患者和一名对照受试者在接受0、2或4毫克格隆溴铵后，在温暖的气候控制室内按照运动方案在跑步机上跑步（速度为5.4 - 6.7英里/小时，坡度为1°）。监测两名受试者的核心体温、心率、主观用力程度分级和出汗率。
格隆溴铵剂量与出汗率降低及最高核心体温之间无显著相关性。然而，降低出汗率的临床效果非常显著。受试者出汗率的改善使其能够成功重返运动。
我们的研究结果表明，低剂量格隆溴铵可能是控制运动性多汗症的一种安全有效的方法。
