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Frontiers in Neurology 2019We report a woman with unilateral Adie's pupil associated with peripheral sensorimotor polyneuropathy, elevated anti-Hu antibody, and primary mediastinal small cell...
We report a woman with unilateral Adie's pupil associated with peripheral sensorimotor polyneuropathy, elevated anti-Hu antibody, and primary mediastinal small cell carcinoma (SCC). To our knowledge, this is the first report of Adie's pupil in a patient with mediastinal SCC. Although rare, Adie's pupil and sensorimotor polyneuropathy may be the first manifestation of cancer. Its rapid recognition facilitates an early diagnosis and treatment.
PubMed: 31849812
DOI: 10.3389/fneur.2019.01236 -
BMJ Case Reports Jan 2020A 40-year-old healthy man presented with a 4-month history of photophobia, blurred vision and a right dilated pupil. Examination revealed a right pupil that was not...
A 40-year-old healthy man presented with a 4-month history of photophobia, blurred vision and a right dilated pupil. Examination revealed a right pupil that was not reactive to light but constricted strongly to a near target and slowly redilated when he looked back in the distance. Pharmacological testing with dilute pilocarpine 0.1% resulted in constriction of the right pupil but no change in the left pupil. This also resulted in resolution of his photophobia and blurry vision. Neurological examination was otherwise normal, and a diagnosis of Adie's tonic pupil was made. The main differential diagnosis to consider for a large pupil is a third nerve palsy, pharmacological mydriasis, tonic pupil and local iris processes, such as iris sphincter tears from trauma. Knowledge of the key features of these conditions can avoid wasted resources from unnecessary testing. Dilute pilocarpine 0.1% three times a day can be considered as a pharmacological therapy for symptomatic relief.
Topics: Adie Syndrome; Adult; Diagnosis, Differential; Humans; Male; Photophobia; Pilocarpine; Tonic Pupil
PubMed: 31900299
DOI: 10.1136/bcr-2019-233136 -
Neuro-ophthalmology (Aeolus Press) Oct 2015Adie's pupil is characterised by pupil dilatation, segmental iris palsy, light-near dissociation, and slow re-dilatation. Most commonly, tonic pupils are unilateral and...
Adie's pupil is characterised by pupil dilatation, segmental iris palsy, light-near dissociation, and slow re-dilatation. Most commonly, tonic pupils are unilateral and idiopathic, but can be caused by orbital disorders and autonomic neuropathies. There are only a few case reports of tonic pupils in patients with Sjögren's syndrome, caused by an autoimmune ciliary ganglionitis. The authors report on two cases with bilateral tonic pupils as the initial manifestation of primary Sjögren's syndrome. Both patients presented with blurred vision, bilateral tonic pupils, and sicca symptoms. The findings suggest that Sjögren's syndrome should be considered in patients presenting with bilateral Adie's tonic pupils.
PubMed: 27928364
DOI: 10.3109/01658107.2015.1067231 -
Journal of Investigative Medicine High... 2023We are reporting monochorionic, diamniotic twin premature infants born at 25 weeks and 6 days gestation with riboflavin (vitamin B2) and biotin (vitamin B7) deficiency,...
Twin Premature Infants With Riboflavin and Biotin Deficiency Presenting With Refractory Lactic Acidosis, Rash, and Multiorgan Failure During Prolonged Parenteral Nutrition.
We are reporting monochorionic, diamniotic twin premature infants born at 25 weeks and 6 days gestation with riboflavin (vitamin B2) and biotin (vitamin B7) deficiency, while on prolonged total parenteral nutrition (TPN) during vitamin shortage. They presented initially with skin rash, lactic acidosis, and thrombocytopenia. Both twins progressed to severe respiratory failure, severe lactic acidosis, with refractory vasodilatory shock, pancytopenia, ischemic bowel injury, acute kidney injury, liver injury, and capillary leak syndrome leading to death of twin A. The surviving twin B was diagnosed with riboflavin and biotin deficiency that presented with abnormal metabolic work up suggestive of maple syrup urine disease, glutaric acidemia type 2, and X-linked adrenoleukodystrophy. Twin B was started on riboflavin and biotin supplementation at 41 days of life, with rapid improvement in clinical findings and laboratory abnormalities within days of starting biotin and riboflavin supplementation. He was discharged home in stable condition at 49 weeks of postmenstrual age.
Topics: Male; Infant, Newborn; Infant; Humans; Acidosis, Lactic; Biotin; Thiamine Deficiency; Parenteral Nutrition; Infant, Premature; Riboflavin; Vitamins; Exanthema; Multiple Organ Failure
PubMed: 37085971
DOI: 10.1177/23247096231168111 -
The Pan African Medical Journal 2015
Topics: Adie Syndrome; Adolescent; Diagnosis, Differential; Female; Humans
PubMed: 26213604
DOI: 10.11604/pamj.2015.20.330.4437 -
The British Journal of Ophthalmology Feb 1984A patient with giant cell arteritis and ischaemic optic neuropathy developed bilateral tonic pupils. This pupillary abnormality may result from ischaemia of the ciliary...
A patient with giant cell arteritis and ischaemic optic neuropathy developed bilateral tonic pupils. This pupillary abnormality may result from ischaemia of the ciliary ganglia. Despite the propensity for patients with giant cell arteritis to develop vascular occlusions in the eye and orbit, tonic pupils have rarely been described, and several reasons for this are proposed. The arteries supplying the ciliary ganglia are frequently involved in giant cell arteritis, but their anastomotic pattern may confer protection from ischaemia. Tonic pupils may also be overlooked amidst the more dramatic manifestations of giant cell arteritis.
Topics: Adie Syndrome; Ciliary Body; Female; Ganglia, Parasympathetic; Giant Cell Arteritis; Humans; Ischemia; Middle Aged
PubMed: 6691957
DOI: 10.1136/bjo.68.2.135 -
The British Journal of Ophthalmology Apr 1944
PubMed: 18170002
DOI: 10.1136/bjo.28.4.190 -
The British Journal of Ophthalmology Jul 1975Two cases of tonic pupil, hyporeflexia, and segmental hypohidrosis (Ross' syndrome) are reported. The relationship of this syndrome to other autonomic dysfunction is...
Two cases of tonic pupil, hyporeflexia, and segmental hypohidrosis (Ross' syndrome) are reported. The relationship of this syndrome to other autonomic dysfunction is discussed. Those symptoms (emotional instability, loss of sweating, orthostatic hypotensive symptoms, and signs of bilaterality of the tonic pupil) which should alert the clinician to more extensive disease states are noted. It is suggested that these conditions may represent a continuum or spectrum of disorders with a widespread degree of severity and progression.
Topics: Adie Syndrome; Adult; Affective Symptoms; Diagnosis, Differential; Eye Diseases; Female; Humans; Hypohidrosis; Middle Aged; Pupil; Reflex, Pupillary; Reflex, Stretch; Syndrome; Time Factors
PubMed: 1191625
DOI: 10.1136/bjo.59.7.387 -
Transactions of the American... 1967
Topics: Adie Syndrome; Adult; Aged; Female; Humans; Male; Methacholine Compounds; Methods
PubMed: 6080175
DOI: No ID Found -
European Respiratory Review : An... Sep 2012
Topics: Adie Syndrome; Aged; Cough; Diabetic Neuropathies; Female; Gastroesophageal Reflux; Hereditary Sensory and Autonomic Neuropathies; Humans; Male; Mononeuropathies; Predictive Value of Tests; Prognosis; Reflex
PubMed: 22941891
DOI: 10.1183/09059180.00000212