Title:
Ross' Syndrome: A Case Report

Authors:
Katia Mabiael Moreno Cortez, Diego Antonio Hidalgo Díaz, Ildefonso Rodríguez Leyva, Mexico

Abstract:

Introduction: Ross syndrome is characterized by the triad of diffuse anhidrosis, myotatic hyporeflexia, and tonic pupil of Adie, with compensatory hyperhidrosis. The evolution of the disease is benign and chronic, its etiology is not well defined, and the pathophysiology involves denervation of autonomic fibers. Approximately 60 cases have been reported worldwide. Therefore, we believe it is relevant to share this case with the medical community, given its characteristics.
Clinical Case: A 39-year-old female started two years ago with profuse diaphoresis, erythema on the left hemibody of insidious onset, progressive, accompanied by contralateral hypohidrosis. On neurological examination with mydriatic right pupil, photo motor and consensual reflex absent; however, accommodation reflex was preserved. On motor examination with preserved strength and global myotatic reflexes abolished. A diagnostic protocol is performed to rule out primary differential diagnoses, which, when excluded, is concluded with Ross' syndrome diagnosis. In addition, a complete laboratory workup was done to rule out systemic problems, nerve conduction studies for radicular-neuropathies, immunological to rule out lupus and other autoimmune diseases, and imaging studies both CT and MRI.
Conclusions: Ross' syndrome thoroughly presents in most patients with the characteristic triad; it is usually progressive and associated with autonomic symptoms. Its importance lies in evaluating and ruling out possible differential diagnoses and the timely treatment of the symptomatology that becomes disabling and has a social impact on the patient. 

DOI: http://dx.doi.org/10.51505/ijmshr.2021.5405