Key result
Etanercept improves orthostasis and autonomic function in a patient with severe refractory autonomic neuropathy.
Why the study?
Does etanercept improve orthostasis and autonomic function in a patient with severe autonomic neuropathy due to Sjogren's syndrome?
Case Report (n=1)
Does etanercept improve orthostasis and autonomic function in a patient with severe autonomic neuropathy due to Sjogren's syndrome?
Etanercept may offer a therapeutic option for refractory severe autonomic neuropathy associated with autoimmune conditions like Sjogren's syndrome.
May support etanercept in refractory autoimmune autonomic neuropathy; hypothesis-generating and requires prospective validation before practice change.
Orthostasis due to autonomic neuropathy can cause severe debilitation and prove refractory to treatment. This report describes a case of severe sympathetic and parasympathetic autonomic dysfunction as a consequence of acetylcholine receptor antibodies and Sjogren's syndrome. Symptomatic management, plasma fluid expanders, and IVIG therapy failed to offer a salutary response to the condition. Etanercept therapy provided improvement of the orthostasis and autonomic function measured as high and low frequency respiratory effects on heart rate variability as well as enhancement of skin blood flow using Laser Doppler. It would be of considerable interest to determine the effectiveness of etanercept in other autoimmune neuropathies.
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Matthew E. Bourcier (2008) conducted a case report in Polyarthritis and severe autonomic neuropathy (n=1). Etanercept was evaluated on Improvement of orthostasis and autonomic function. Etanercept therapy improved orthostasis and autonomic function in a patient with severe autonomic neuropathy refractory to symptomatic management, plasma fluid expanders, and IVIG therapy.
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