Tuesday, May 24, 2005

Case of the Week

Some patients are difficult to classify. Nephrologists sometimes get referred these miscellaneous cases when other doctors are unsure which specialist they should see. (I don't know why this is. Possibly because, as specialists go, we're mostly good-natured and curious.)

Recently I saw a middle aged man whose complaint was "I stopped sweating three months ago." He had previously exercised several times weekly and sweated profusely. Since then, all sweating stopped and he was forced to give up exercise. Several times daily he took cold showers and drank ice water to help control his body temperature. He avoided sunlight. A basic workup was negative.

I've never seen this before. My best guess is that he has acquired idiopathic generalized anhidrosis, which is a disorder involving inflammation of the sweat glands and/or the sudomotor nerves. You stop sweating. I don't think there's a cure. I sent him to a neurologist for a skin biopsy and further studies and gave him advice on avoiding heat stroke.

(This is an interesting and awful disorder. In medicine, unfortunately, these two adjectives often coexist.)

Technorati Tags: , ,

No comments: