47-jähriger Mann mit, pure autonomic failure und Perniziosa

HISTORY AND CLINICAL FINDINGS: A 47-year-old man with a known and substituted vitamin B12 deficiency presented with increasing symptoms associated with orthostatic hypotension, neck pain and micturitional and visual disturbances. CLINICAL AND LABORATORY TESTS: Catecholamines were strongly reduced in plasma and urine. DIAGNOSIS, TREATMENT AND CLINICAL COURSE: A pure autonomic failure was diagnosed and therapy with fludrocortisone, yohimbine and erythropoetine was started. Symptoms with the exception of micturitional disturbances improved strongly. CONCLUSIONS: Multiple-drug treatment of pure autonomic failure is successful. The prognosis is good.