Kampo Medicine  2011;62(6):736-743

doi:10.3937/kampomed.62.736

Keishikashakuyakuto Ameliorated Diverse Autonomic Symptoms such as Diarrhea, Abdominal Pain,Urinary Retention and Orthostatic Hypotension in a Case of Pure Autonomic Failure

Hiroaki HIKIAMI ; Kanoko YAMAMOTO ; Shinji NAKATA ; Tatsuya NOGAMI ; Makoto FUJIMOTO ; Hirozo GOTO ; Naotoshi SHIBAHARA ; Yutaka SHIMADA

Keywords

pure autonomic failure (PAF); abdominal pain; urinary retention; orthostatic hypotension; keishikashakuyakuto

Country

Japan

Language

Japanese

Abstract

Pure autonomic failure (PAF) is a degenerative disorder with diverse autonomic nervous symptoms, but without somatic nervous symptoms. We encountered a patient with PAF who was successfully treated with keishikashakuyakuto. A 61-year-old man complained of diarrhea, abdominal pain, dysuria and orthostatic hypotension. PAF was strongly suspected, based on a low level of plasma noradrenalin at rest and a finding of severe diffuse sympathetic nerve injury on 123I MIBG myocardial scintigraphy. Various Kampo formulas were not effective, or could not be administered continually. Urinary retention was treated with self-catheterization. After the extract of keishikashakuyakuto was administered, his complaints of diarrhea and abdominal pain gradually decreased, and he was able to eat various kinds of food. His daily living activities improved.Moreover, he could urinate by himself, so the self-catheterization was stopped. Five years later, the diagnosis of PAF was clinically confirmed, but his daily living activities did not deteriorate. This suggests that keishikashakuyakuto can be effective for diseases with diverse autonomic nervous symptoms, such as the present case.