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<front>
<journal-meta>
<journal-id journal-id-type="issn">1043-3155</journal-id>
<journal-id journal-id-type="nlm-ta">Pediatr Neurol Briefs</journal-id>
<journal-id journal-id-type="pmc">pedneurbriefs</journal-id>
<journal-id journal-id-type="iso-abbrev">Pediatr Neurol Briefs</journal-id>
<journal-title-group>
<journal-title>Pediatric Neurology Briefs</journal-title>
<abbrev-journal-title>Pediatr Neurol Briefs</abbrev-journal-title>
</journal-title-group>
<issn pub-type="epub">2166-6482</issn>
<issn pub-type="ppub">1043-3155</issn>
<issn-l>2166-3155</issn-l>
<publisher>
<publisher-name>Pediatric Neurology Briefs Publishers</publisher-name>
<publisher-loc>Chicago, IL, USA</publisher-loc>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="publisher-id">PNB-7-55-b</article-id>
<article-id pub-id-type="doi">10.15844/pedneurbriefs-7-7-11</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Endocrine Disorders</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v2">
<subject>Neurology</subject>
<subject>Pediatrics</subject>
<subject>Nervous System Diseases</subject>
<subject>Child Development</subject>
<subject>Brain Diseases</subject>
<subject>Neurosurgery</subject>
<subject>Child</subject>
<subject>Infant</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Adrenal, Alacrimal, Achalasia Syndrome</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-0173-7931</contrib-id>
<name>
<surname>Millichap</surname>
<given-names>J. Gordon</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="AF0001">1</xref>
<xref ref-type="aff" rid="AF0002">2</xref>
<xref ref-type="corresp" rid="cor1">&#x002A;</xref>
</contrib>
</contrib-group>
<aff id="AF0001">
<label>1</label>Division of Neurology, Children&#x0027;s Memorial Hospital, Chicago, IL</aff>
<aff id="AF0002">
<label>2</label>Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL</aff>
<author-notes>
<corresp id="cor1"><label>&#x002A;</label>Correspondence: Dr. J. Gordon Millichap, E-mail: <email xlink:href="jgmillichap@northwestern.edu">jgmillichap@northwestern.edu</email>
</corresp>
</author-notes>
<pub-date date-type="pub" publication-format="print">
<month>07</month>
<year>1993</year>
</pub-date>
<pub-date date-type="pub" publication-format="electronic">
<day>01</day>
<month>07</month>
<year>2016</year>
</pub-date>
<volume>7</volume>
<issue>7</issue>
<fpage>55</fpage>
<lpage>56</lpage>
<permissions>
<copyright-statement>Copyright: &#x00A9; 1993 The Author(s)</copyright-statement>
<copyright-year>1993</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/">
<license-p>This work is licensed under the <uri xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution 4.0 International License</uri>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<related-article id="R1" related-article-type="commentary-article" ext-link-type="doi" xlink:href="10.1136/adc.68.6.779" vol="68" page="779">
<article-title>Neurological and adrenal dysfunction in the adrenal insufficiency/alacrima/achalasia (3A) syndrome</article-title>
</related-article>
<abstract abstract-type="web-summary" specific-use="electronic-only">
<p>The results of a British and European Paediatric Endocrinology Society, multicenter collaborative, questionnnaire study of the neurological complications of familial glucocorticoid deficiency syndrome are reported from the Hospital for Sick Children, Great Ormond Street, London.</p>
</abstract>
<kwd-group>
<kwd>Achalasia</kwd>
<kwd>Hyperreflexia</kwd>
<kwd>Hyperkeratosis</kwd>
</kwd-group>
</article-meta>
</front>
<body>
<p>The results of a British and European Paediatric Endocrinology Society, multicenter collaborative, questionnnaire study of the neurological complications of familial glucocorticoid deficiency syndrome are reported from the Hospital for Sick Children, Great Ormond Street, London. Of 20 patients identified, ages 2 to 29 years, all had impaired Cortisol secretion, 19 absent tear secretion, 15 achalasia of the cardia, and 17 had neurologic abnormalities including hyperreflexia, hypertonia, Babinski signs, muscle weakness and/or wasting, ataxia, dysarthria, and sensory impairment. Impaired autonomic function in 11 patients was manifested by postural hypotension and anisocoria. Eleven were intellectually impaired. Ten had hyperkeratosis and fissures of their palms. Siblings were affected in 3 families, and 7 siblings had died in childhood. [<xref ref-type="bibr" rid="CIT0001">1</xref>]</p>
<disp-quote>
<p><bold>COMMENT.</bold> The most frequent presenting symptom was hypoglycemia, often associated with addisonian skin pigmentation. In 4 cases the diagnosis of achalasia preceeded the recognition of Cortisol deficiency. The authors recommend a test of Cortisol secretion in children with achalasia, if associated with alacrima or with any of the above neurologic abnormalities.</p>
</disp-quote>
</body>
<back>
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</article>