Department of General Internal Medicine, National Hospital Organisation Sendai Medical Center, Sendai, Miyagi, Japan.
Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
BMJ Case Rep. 2024 Jan 16;17(1):e258324. doi: 10.1136/bcr-2023-258324.
Dizziness is one of the most common complaints encountered in the outpatient clinic, which is difficult to diagnose, especially in older patients because of the multifactorial nature of the disease. Although not commonly recognised, anhidrosis can also cause dizziness.We report a case of a woman in her 70s who presented with long-term recurrent dizziness. She had a history of frequent hospitalisations for heatstroke. Physical examination revealed markedly less sweating in the left axilla and soles than in the right. Minol test revealed that most of the left side of her body, including the face, was anhidrotic. She was diagnosed with idiopathic segmental anhidrosis. We administered steroid pulse therapy without observing any significant effects.Although anhidrosis is a rare disorder, a careful interview and physical examination should be conducted to confirm a history of heatstroke and the absence of sweating to avoid missing the disease.
头晕是门诊最常见的主诉之一，其诊断较为困难，尤其是老年患者，因为该病具有多因素的性质。虽然不常见，但无汗症也可引起头晕。我们报告一例 70 多岁的女性患者，长期反复发作头晕。她有反复因中暑住院的病史。体格检查发现左侧腋窝和脚底的出汗明显少于右侧。少汗试验显示，她的身体左侧大部分部位（包括面部）无汗。她被诊断为特发性节段性无汗症。我们给予了类固醇脉冲治疗，但未观察到明显效果。尽管无汗症较为罕见，但应仔细询问病史并进行体格检查，以确认是否有中暑史及无汗，从而避免漏诊。
