A case of Ross syndrome presented with Horner and chronic cough

Abstract

Ross syndrome is a rare sweating disorder associated with Adie's tonic pupil, decreased or diminished tendon reflex and unknown etiology. Although autonomic disturbances affecting sudomotor and vasomotor functions are seen commonly, they are rarely symptomatic. While Ross syndrome is typically characterized with dilated tonic pupil, it may be rarely manifested with miotic pupils (little old Adie's pupil), which can make diagnosis difficult. In this article, we aim to specify the atypical clinical manifestations of syndrome by means of Ross syndrome manifested by autonomic symptoms, Horner syndrome, chronic cough together with bilateral little old Adie's pupil.

Is Ross Syndrome an Autoimmune Entity? A Case Series of 11 Patients

“…Mean age of presentation for women was 31 years (22-42) and for men was 27 years . The mean duration of time delay from the onset of symptoms to diagnosis of the disease was 6 years (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). In all patients, this clinical entity was suspected and diagnosed in a tertiary care center.…”

“…Ten percent of these patients can have a nonresponsive sphincter pupillae and most will have some residual light reflex on examination. 6 The aberrant regeneration of nerve fibers following damage to parasympathetic cholinergic fibers between iris and ciliary ganglion leads to progressive miosis in these patients. 5,6,8 The reason for the lost or diminished deep tendon reflexes seen in patients with Ross syndrome remains unknown.…”

An interesting case of simultaneous bilateral Adie's tonic pupil

“…Baran et al . and Mayer[ 2 3 ] in separate case reports have reported patients with bilateral tonic pupils as a part of the syndromic presentation of Ross syndrome. A rare presentation of bilateral Adie's pupil as a part of Vogt–Koyanagi–Harada has been reported in literature by Kim et al .…”

Ross syndrome: A case report and review of cases from India

“…Management depends on the predominant symptomatology. If hyperhidrosis is the chief complaint botulinum toxin,[ 10 ] iontophoresis,[ 11 ] aluminum chloride, 0.5% glycopyrrolate,[ 12 ] sympathetic thoracotomy[ 13 ] and systemic anticholinergics have been advocated with varying results. On the other hand, management of hypohidrosis relies on nonpharmacological measures such as avoidance of hot environment and wearing wet clothes during strenuous activities.…”