Abstract. Allgrove’s or “4 A” syndrome is a rare autosomal recessive condition with alacrima, achalasia, autonomic disturbance, and ACTH insensitivity among. Triple-A syndrome or AAA syndrome, also known as achalasia-addisonianism- alacrima syndrome or Allgrove syndrome, is a rare autosomal recessive. Disease summary: Allgrove Syndrome (AS) is rare autosomal recessive disorder characterised by achalasia cardia, alacrimia and adrenal insufficiency, which is.

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The syndrome involves achalasiaaddisonianism adrenal insufficiency of primary typeand alacrima insufficiency of tears. The syndrome is highly variable. Volume Issue 2.

Familial glucocorticoid deficiency with achalasia of the cardia and deficient tear production. Triple A syndrome is a very rare multisystem disease characterized by adrenal insufficiency with isolated glucocorticoid deficiency, achalasia, alacrima, autonomic dysfunction and neurodegeneration.

Responses are now closed for this article. J Clin Endocrinol Metab ; From Wikipedia, the free encyclopedia. A diagnosis of Allgrove syndrome was made clinically, and adrenal insufficiency was confirmed with the discovery allgroev elevated ACTH and low basal cortisol levels see Box 1. This page was last edited on 28 Augustat Triple-A syndrome or AAA syndromealso known as achalasia-addisonianism-alacrima syndrome or Allgrove syndrome[1] is a rare autosomal recessive congenital disorder.

A diagnosis of primary adrenal insufficiency usually includes consideration of an autoimmune basis where adrenal antibody status should be tested with or without other pointers to polyautoimmune endocrinopathyinfective causes tuberculosis, viruses and mycoses and, in older patients, malignant infiltration. Topics Endocrine system diseases. Only comments written in English can be processed.

Diagnostic methods Diagnosis is based on clinical examination and adrenal function testing. By using this site, you agree to the Terms of Use and Privacy Policy.


Clinical description The onset of Triple A syndrome varies between infancy and adulthood. In most cases, there is no family history of it. Peripheral motor and sensory neuropathy are common, 10 and may be subtle in childhood.

Triple-A syndrome – Wikipedia

Glucocorticoid and partial mineralocorticoid deficiency associated with achalasia. Disease definition Triple A syndrome is a very rare multisystem disease characterized by adrenal insufficiency with isolated glucocorticoid deficiency, achalasia, alacrima, autonomic dysfunction and neurodegeneration. One year before admission, he had a 2-day history of lethargy, dizziness, and collapse with hypotension.

Previous history One year before admission, he had a 2-day history of lethargy, dizziness, and collapse with hypotension.

Diagnosis of hypocortisolism is frequently delayed for patients with adrenal insufficiency, because of the subtle nature of clinical complaints weakness, tiredness, dizziness synrrome slow weight loss.

A neurological report described mixed motor neurone abnormalities, with symmetrical four-limb weakness, predominantly distal muscle wasting, bilateral pes cavus, symmetrical hyperreflexia and positive Babinski reflexes.

Current admission An endocrinological consultation was sought because of increasing lethargy, weakness and reported testicular atrophy. Differential diagnosis thus includes other causes of adrenal insufficiency, achalasia or alacrima such as frequent forms of congenital adrenal hyperplasia easily excluded with dosage of adrenal hormones precursorsand rare peripheral forms of congenital adrenal insufficiency or adrenoleukodystrophy, which might be associated with neurological features.

Triple-A syndrome

Unlike other neurological disorders associated with adrenal insufficiency, neurological change with Allgrove syndrome is extremely slow. Additional information Further information on this disease Classification s 6 Gene s 3 Clinical signs and symptoms Publications in PubMed Other website s 5. D ICD – Hum Mol Genet ; 5: Although most cases of Allgrove syndrome are diagnosed during childhood, awareness of this condition when undiagnosed in adults is crucial, as it is life threatening, and can severely affect neurological, sexual and psychological function.


When presenting in early childhood, alacrima and, possibly, achalasia are the indicative signs; in childhood and adolescence, onset aolgrove characterized by achalasia and adrenal insufficiency; while in adulthood, presentation is predominantly neurological with autonomous and polyneuropathic involvement. Publication of your online response is subject to the Medical Journal of Australia ‘s editorial discretion.

Allgrove syndrome: when a recognisable paediatric disorder occurs in adulthood

Infobox medical condition new Articles to be expanded from August All articles to be expanded Articles with empty sections from August All articles with empty sections Articles using small message boxes.

Views Read Edit View history. When mineralocorticoid function is intact, postural hypotension and electrolyte disturbance, with an acute medical emergency presentation, is less likely. Achalasia was diagnosed on radiological and endoscopic findings, with symptomatic improvement following pneumatic dilatation.

With syndroke cortisol replacement, monitoring of ACTH levels and education to ensure appropriate synfrome in corticosteroid treatment during intercurrent illness or anaesthesia, the prognosis for health and quality of life is improved. Bulbar involvement and optic atrophy were observed.

Discussion This patient with Allgrove syndrome, who developed symptoms of severe life-threatening adrenal insufficiency at age 36, but retained normal mineralocorticoid function, is syndroms oldest reported case surviving with undiagnosed adrenal insufficiency.

Indian Journal of Gastroenterology. There was significant improvement in his speech, cessation of cough and reported normalisation of eating habits.