Case report: a case of acute autonomic and sensory neuropathy with fluctuating symptoms and literature review

Purpose By reporting a patient with acute autonomic neuropathy (AASN) and reviewing relevant literature, we aim to improve understanding of the disease and assist in early clinical diagnosis and treatment. Methods The clinical data and treatment of a patient with AASN who was admitted to our hospital were summarized, and the previously reported AASN cases or case series were systematically analyzed to summarize the gender, age of onset, prodromal infection, clinical manifestations, auxiliary examinations, treatment and prognosis of the patients. Results The patient was a 50-year-old female who complained with “paresthesia and dizziness for more than 7 months”. In the early stage of the disease, the patient showed abnormal pain, dizziness, and sensory ataxia, without limb muscle weakness. Retrospective analysis of AASN case reports showed that the age of onset was 34.15 ± 17.43 years old, the male-female ratio was 3:10, and most of them had a history of prodromal infection. Previous literature reports on the treatment of AASN patients mainly included symptomatic supportive treatment and immunomodulatory treatment with hormones or intravenous immunoglobulin. Most patients gradually recover from autonomic nervous system symptoms after treatment, while sensory deficits persist. Conclusions AASN is a rare, rapidly progressive disease involving autonomic and sensory nerves, often secondary to upper respiratory or digestive tract infections. Clinical manifestations include hypoesthesia, hyperalgesia, digestive and cardiovascular dysfunction, etc. AASN patients should be identified as early as possible and given immunomodulatory therapy and symptomatic treatment in order to improve the prognosis.