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Glucocorticoid insufficiency, Achalasia, Alacrima with autonomic and motor neuropathy

Stuckey, B.G.A., Mastaglia, F.L., Reed, W.D. and Pullan, P.T. (1987) Glucocorticoid insufficiency, Achalasia, Alacrima with autonomic and motor neuropathy. Annals of Internal Medicine, 106 (1). pp. 62-64.

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We report the case of a patient with adrenal disease with achalasia and alacrima, which appear to be part of a widespread defect in adrenal and nervous system function.

A 21-year-old white woman at age 6 had had hypoglycaemia, hyperpigmentation, low plasma cortisol level (30 nmol/L; normal, 200 to 600), and a lack of cortisol response to cosyntropin. Alacrima had been noted since infancy but there were no other abnormal neurologic features. A roentgenogram of the chest at age 9 showed bilateral pulmonary opacities presumed due to aspiration; these have persisted. Nocturnal cough, vomiting of undigested food, and recurrent chest...

Item Type: Journal Article
Publisher: American College of Physicians
Copyright: 1987 American College of Physicians
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