Paroxysmal hypothermia and hyperhidrosis with exacerbation after COVID-19 Infection
2021; Springer Science+Business Media; Volume: 31; Issue: 2 Linguagem: Inglês
10.1007/s10286-021-00783-9
ISSN1619-1560
AutoresGuillaume Lamotte, Eduardo E. Benarroch, Elizabeth A. Coon,
Tópico(s)Thermal Regulation in Medicine
ResumoDear editors,We present the case of a 49-year-old woman with exacerbation of paroxysmal hyperhidrosis and hypothermia after COVID-19 infection.A 49-year-old woman presented to the autonomic disorder clinic for evaluation of paroxysmal hyperhidrosis and hypothermia.Starting at age 46, she experienced episodes of hyperhidrosis, most pronounced in the face and upper body, followed by profound hypothermia (32-33 °C) associated with confusion and lethargy.Episodes were triggered by minimal intensity physical activity and heat exposure.Each episodes lasted 3-6 h, and they happened on average once per month.Her medical history was significant for hypertension as well as endometriosis and ovarian cyst treated with total abdominal hysterectomy and bilateral salpingooophorectomy. Neurological examination was unremarkable.Laboratory testing including thyroid and adrenal function tests was unremarkable.Magnetic resonance imaging of the brain was unremarkable, with intact corpus callosum.Standardized autonomic testing revealed normal postganglionic sympathetic sudomotor, cardiovagal, and cardiovascular adrenergic functions.A thermoregulatory sweat test (TST) demonstrated lower extremity anhidrosis.The results of the TST and quantitative sudomotor axon reflex test were consistent with preganglionic (central) sudomotor dysfunction (Fig. 1).The patient was diagnosed with Shapiro syndrome variant.She started clonidine extendedrelease 0.1 mg daily by mouth with complete resolution of the symptoms.She was able to resume her daily activities without any limitations.
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