Ross syndrome

Abstract

Introduction: Ross syndrome is a rare entity of the nervous system classified within dysautonomic syndromes, with few cases reported in the literature since its description in 1958. It more frequently affects men than women between the ages of 3 and 50 years and, as a characteristic clinical triad, manifests as segmental anhidrosis, Adie’s tonic pupil, and osteotendinous areflexia.

Objective: To present the clinical, pathophysiological, and therapeutic features of a patient with Ross syndrome.

Case report: A 58-year-old male patient is presented with left-sided hypohidrosis and contralateral hyperhidrosis of 20 years’ duration, accompanied by osteotendinous areflexia, chronic diarrhoea, and hypotonic pupils. Due to its rarity and limited awareness, clinical suspicion is warranted, as although this disorder does not cause severe impairments, it affects the quality of life of those affected.

Conclusions: Dysautonomic disorders that produce anhidrosis or hyperhidrosis can accompany multiple diseases in daily clinical practice and, therefore, should be recognized by various medical specialties, such as dermatology, neurology, internal medicine, and ophthalmology, to enable timely diagnosis. Ross syndrome does not appear to be as rare as once thought, with increasing reports emerging in the scientific literature, highlighting the need for further study of disorders of the sympathetic and parasympathetic nervous systems, their underlying pathophysiology, and the therapeutic options available for the timely treatment of affected patients.