Reduced saliva and sweat

Introduction Saliva and sweat reduction are clinical manifestations of acute total autonomic dysfunction. The cause is not yet clear. The disease has been found to occur after infectious mononucleosis and dysentery; some cases show increased antibody titers to Epstein-Barr virus. Some people think that this disease is autoimmune autonomic neuropathy, similar to neurotropic virus infection; but it is currently considered to be an abnormal immune response to autonomic ganglia or postganglionic nerve fibers.

Cause

Causes of reduced saliva and sweat:

(1) Causes of the disease

The cause is not yet clear. The disease has been found to occur after infectious mononucleosis and dysentery; some cases show increased antibody titers to Epstein-Barr virus. Some people think that this disease is autoimmune autonomic neuropathy, similar to neurotropic virus infection; but it is currently considered to be an abnormal immune response to autonomic ganglia or postganglionic nerve fibers.

(two) pathogenesis

There is currently a tendency to believe that the disease is associated with an abnormal immune response following viral infection.

1. Peripheral nerve autoimmune dysfunction Domestic and foreign scholars with sural nerve biopsy showed that the myelin fibers and unmyelinated fibers were significantly reduced in this disease, with axonal degeneration, the lesion mainly occurred in small fibers, and inflammatory demyelination The performance is consistent. Some patients with peripheral nerve sensation, dyskinesia, cerebrospinal fluid protein quantitative increase, normal cell number, good prognosis. Therefore, some people think that this disease is a special type of Guillain-Barre syndrome.

2. Viral infection In recent years, some neurotropic viruses have been found to directly invade autonomic ganglia and post-ganglionic fibers, which may be an important mechanism leading to this disease. Besnard et al (2000) reported that a patient with intestinal obstruction as the main manifestation was positive for EB virus in hemorrhage and cerebrospinal fluid by PCR, and further detected by RNA probe in situ hybridization in the small intestine muscle layer, mesenteric lymph node and stomach. Department of Epstein-Barr virus.

Pathological changes of the disease: mainly occur in the peripheral or central autonomic nervous system; directly affect the function of the peripheral ganglia or postganglionic sympathetic and parasympathetic nerves. It is characterized by the disappearance of neurons, the proliferation of collagen fibers in the nodules, demyelination, and axonal degeneration. The sural nerve biopsy has no abnormality during the onset of the disease, but patients with autonomic dysfunction still exist after several years of onset. It can be seen that the number of unmyelinated nerve fibers is increased compared with normal, accompanied by regenerative changes.

an examination

Related inspection

Determination of trace elements in the human body by routine examination of blood cerebrospinal fluid (CSF)

Diagnosis of reduced saliva and sweat:

Acute total autonomic dysfunction is more common in children and adults. It is characterized by extensive or incomplete paralysis of the autonomic nerves, such as blurred vision, abnormal pupillary response to light and regulation, large pupils, and decreased or disappeared secretion of tears, saliva and sweat. And urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

Differential diagnosis

Saliva and sweat reduction should be differentiated from Guillain-Barre syndrome, diabetes, or alcoholic neuropathy, familial autonomic dysfunction.

1. The disease is usually acute onset, more common in children and adults, manifested as extensive or complete paralysis of autonomic nerves, such as blurred vision, pupillary light and regulation response abnormalities, pupils are not large, tear, saliva and sweat secretion decreased Or disappear, as well as urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

2. It can cause syncope due to orthostatic hypotension, but the heart rate is normal at this time. A small number of patients may be accompanied by peripheral nerve movements and sensory disturbances.

The diagnosis of this disease is mainly based on the clinical manifestations of acute majority of autonomic dysfunction symptoms.

Diagnosis: Acute total autonomic dysfunction is more common in children and adults. It is characterized by extensive or incomplete paralysis of the autonomic nerves, such as blurred vision, abnormal pupillary response to light and regulation, large pupils, reduced secretion of tears, saliva and sweat, or Disappeared, as well as urinary retention, impotence, gastrointestinal dysfunction (nausea, vomiting, constipation, bloating or diarrhea) and abnormal body temperature regulation.

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