The etiology of autonomic neuropathy in insulin-dependent diabetes mellitus (IDDM) is unknown. Previous studies have noted the presence of anti-adrenal medullary antibodies in IDDM. Recently, we have also demonstrated the presence of anti-sympathetic ganglia antibodies in IDDM. We initiated a study to evaluate whether subjects with complement-fixing anti-adrenal medullary (CF-ADM) and anti-sympathetic ganglia (CF-SG) antibodies have a decreased catecholamine response to change in posture. Seven IDDM subjects aged 19–41 yr with duration of disease 5–21 yr at the time of the posture study were evaluated. Serums collected longitudinally were evaluated for the presence of CF-ADM and CF-SG antibodies. Three IDDM subjects were CF-ADM− and CF-SG− at all testing intervals (Ab− group). Four IDDM subjects were CF-ADM+ and/or CF-SG+ on at least one testing date (Ab+ group). Baseline mean norepinephrine and epinephrine levels were not significantly different in Ab+ and Ab− subjects. Norepinephrine levels 5 min after standing were mean ± SD 227 ±16 and 419 ± 48 pg/ml for Ab+ and Ab− subjects, respectively (P < .03). The means of the 5-min minus basal norepinephrine levels were 88 ± 42 (Ab+) and 207 ± 26 (Ab−) pg/ml (P < .03). Mean epinephrine levels after 5 min of standing were 35 ±16 (Ab+) and 101 ± 44 (Ab−) pg/ml (P < .03). The means of the 5-min minus basal epinephrine levels were 1 ± 5 (Ab+) and 43 ± 38 (Ab) pg/ml (P < .03). Mean change in systolic blood pressure on standing was not different in the two groups. This suggests that CF-ADM and CF-SG are associated with a decreased catecholamine response to change in posture.
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July 01 1989
Anti-Sympathetic Nervous System Autoantibodies: Diminished Catecholamines With Orthostasis
Florence M Brown;
Florence M Brown
Immunology Section, Joslin Diabetes Center; the Division of Diabetes and Metabolism, Brigham and Women's Hospital; Harvard Medical School; Children's Hospital Medical Center, Neurology Section, New England Deaconess Hospital
Boston
New England Diabetes and Endocrine Center
Chestnut Hill, Massachusetts
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Stuart J Brink;
Stuart J Brink
Immunology Section, Joslin Diabetes Center; the Division of Diabetes and Metabolism, Brigham and Women's Hospital; Harvard Medical School; Children's Hospital Medical Center, Neurology Section, New England Deaconess Hospital
Boston
New England Diabetes and Endocrine Center
Chestnut Hill, Massachusetts
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Roy Freeman;
Roy Freeman
Immunology Section, Joslin Diabetes Center; the Division of Diabetes and Metabolism, Brigham and Women's Hospital; Harvard Medical School; Children's Hospital Medical Center, Neurology Section, New England Deaconess Hospital
Boston
New England Diabetes and Endocrine Center
Chestnut Hill, Massachusetts
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Steven L Rabinowe
Steven L Rabinowe
Immunology Section, Joslin Diabetes Center; the Division of Diabetes and Metabolism, Brigham and Women's Hospital; Harvard Medical School; Children's Hospital Medical Center, Neurology Section, New England Deaconess Hospital
Boston
New England Diabetes and Endocrine Center
Chestnut Hill, Massachusetts
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Address correspondence and reprint requests to Steven L. Rabinowe, MD, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215.
Diabetes 1989;38(7):938–941
Article history
Received:
March 09 1989
Revision Received:
April 28 1989
Accepted:
April 28 1989
PubMed:
2737366
Citation
Florence M Brown, Stuart J Brink, Roy Freeman, Steven L Rabinowe; Anti-Sympathetic Nervous System Autoantibodies: Diminished Catecholamines With Orthostasis. Diabetes 1 July 1989; 38 (7): 938–941. https://doi.org/10.2337/diab.38.7.938
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