ACRODYNIA (Greek akron — an extremity and odyne — pain; synonym: Zelter's disease, Swift's disease — Feera; unsuccessful synonym: eritredema, vegetative neurosis, trophoneurosis, rozgovy disease) — the disease of a nervous system, is preferential at children up to 5 years, expressed peculiar vegetative and somatic disturbances, and also frustration of mentality.
Etiology it is not established. According to one authors, the infectious disease caused by an unknown virus; according to others — And. it is connected with exchange disturbances, apparently, of avitamonous character (a hypovitaminosis of B6); according to the third — And. it is connected with an endointoxication; there is also an opinion that a basis And. neuroallergic reaction on various harm is. The disease meets quite seldom.
Pathological anatomy. Reveal diffusion inflammatory changes in a head, spinal cord, sympathetic and parasympathetic ganglions. The hypothalamus and side columns of a spinal cord are preferential struck. At hron. a current degenerative changes of the same areas prevail.
Clinical picture. Boys and girls get sick equally often. Current And. can be acute and chronic.
The disease in some cases can begin with loss of appetite, fervescence, irritability, alarm, melancholy, a photophobia, change of behavior, emergence of tendency to a privacy. The sharp hyperemia or cyanosis and a cold snap of skin of brushes and feet, humidity («beef-steak hands») or excessive dryness, a peculiar puffiness, a severe itch and pains in affected areas of skin is characteristic. The hyperhidrosis, a peeling of skin, pigmentation, a hyperkeratosis, loss and canities of hair, formation of ulcers with the subsequent gangrene and rejection of phalanxes of fingers can be observed. Vasculomotor frustration, a hyperhidrosis, an itch and pains sometimes take the form of a paroxysm lasting up to 30 min. Pains decrease during the wetting of skin a cold water and during the blowing of extremities. The sleep (drowsiness, sleeplessness) is often interrupted. At some patients the hyperthermia, the expressed tachycardia, high arterial pressure come to light. The respiratory rhythm changes, there is an excessive thirst, excess appetite. Secretion of sweat and other glands increases (plentiful dacryagogue, allocations from a nose, hypersalivation, etc.). Various trophic disorders, ulcers on a mucous membrane of a mouth develop, teeth drop out. There are abdominal pains and ponosa. There are mental disturbances in the form of depressive frustration, hallucinations, psychomotor excitement. At patients the atony of muscles, decrease in their force (paresis), an areflexia is observed. Along with peripheral paresis and paralyzes And occasionally also the central paresis, paralyzes develop. Some patients can have epileptic seizures, twitching of muscles, trembling. Miastenopodobny syndromes are described (see the Myasthenia).
In blood the quantity of erythrocytes quite often increases, at some patients the leukocytosis (increase in polinuklear) comes to light, there is a hyperglycemia. The amount of urine can be reduced, the glucosuria sometimes comes to light. Normal cerebrospinal fluid or is defined moderate increase in protein, sometimes uniform elements. Complications are possible: maceration of skin, a raschesa, an ulcer on a mucous membrane of a mouth, gangrene, nasopharyngites that can lead to septic conditions of various weight. Bronchial pneumonia can develop.
Diagnosis. The combination of paroxysmal pains to feeling of heat, reddening and perspiration of distal departments of extremities to peculiar mental disturbances, miastenopodobny symptoms, tachycardia is characteristic. In the onset of the illness when behavior disorders or vegetative frustration prevail, there can be a need to carry out the differential diagnosis with mental diseases and a vegetative polyneuritis. In process of development of a disease the diagnosis becomes obvious.
Forecast is defined by intensity of pathological process and timely purpose of treatment. In most cases — favorable. At a heavy current and development of complications the lethal outcome is possible.
Treatment. Good, vitamin-rich regular nutrition. The good result from purpose of a crude liver is described. Administration of vitamins (With, B1, B6, nicotinic to - that), drugs of cholinolytic action (atropine, a belladonna, a spasmolysant), calmatives (Trioxazinum), protivogistamiyny drugs (Dimedrol, Pipolphenum) is recommended. Doses of drugs are established depending on age of the patient. From physiotherapeutic procedures use uv radiation, a hydrotherapy. Apply ointments with anaesthesin to reduction of an itch and feeling of heat, etc.
Bibliography: Fankoni G. and Valgren And. The guide to children's diseases, the lane with it., page 732, M., 1960: Tsuker M. B. Fundamentals of neuropathology of children's age, page 437, M., 1947; Péhu M. et Boucomont J. L'acrodynie infantile, P., 1944, bibliogr.
N. N. Anosov.