Acquired Idiopathic Generalized Anhidrosis following Left Lumbar Sympathetic Ganglion Block (L2 and L3): a Case Report

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A 47-year-old man had reflex sympathetic dystrophy of the left foot following fracture of the tibia. The patient had been treated with left L2 and L3 ethanol sympathetic ganglion blockades twice. Soon after the first blockade, he had a loss of sweating of both lower legs. A second blockade was performed one year following the first blockade. About eight months after the second blockade, he had a complete loss of sweating of the entire body except for the face. The only abnormal neurological finding was anhidrosis. Reflex sweating test to acetylcholine was negative, which result suggested that the anhidrosis was based on a disorder of postganglionic pseudomotor nerves or cholinergic receptors. Skin biopsy revealed that CD3 positive lymphocytes were dominant around the sweat glands of the anhidrotic lesion. To rule out the possible diagnosis of acquired idiopathic generalized anhidrosis, glucocorticoid. Therapy was started, however, anhidrosis persisted.
一般社団法人日本ペインクリニック学会の論文