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Effects of non-pharmacological sympathetic sudomotor denervation on sweating in humans with essential palmar hyperhidrosis

par Noppen, Marc;Sevens, Claude ;Vincken, Walter
Référence Clinical biochemistry, 30, 2, page (171-175)
Publication Publié, 1997-03

Article révisé par les pairs

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Résumé :

Objectives: Quantitative sweat production and -ionic composition in Essential Hyperhidrosis (EH), and the effects of T2-T3 thoracoscopic sympathicolysis (TS) hereon, are unknown. Standardised pilocarpine iontophoresis sweat tests were performed before and after TS in order to study these issues. Design and Methods: Pilocarpine iontophoretic sweat tests measuring maximal sweat production (rag) and sweat Na+, K+ and CIconcentrations (mMol/L) were performed on both forearms of 10 EH patients, before and six weeks after TS, and in normal volunteers. Results: As compared to normals, preoperative maximal sweat production was 30% higher (199.4 ± 68.8 (SD) vs. 150.6 ± 45.6 Mg) in EH patients; due to type II error, however, statistical significance was not reached. Na+ and Cl- concentrations were similar, and K+ concentration was slightly lower in EH patients. After TS, sweat production had decreased to equal levels as in normals (149.1 ± 52.1 mg), whereas the Na+ (from 33.6 ± 6.9 to 51.0 ± 6.4 mMol/L), Cl- (from 21.5 ± 6.6 to 37.2 ± 7.1 mMol/L) and K+ (from 7.5 ± 1.3 to 8.6 ± 2.2 mMol/L) concentrations had increased. Conclusions: EH patients present 30% higher maximal sweat production at their forearms. This increase may be due to an increased activity of the adrenergic component of sweat gland innervation. The post-TS increase in Na+, Cl- and K+ concentrations suggests that the adrenergic component of sweat gland innervation in itself decreases sweat ion concentrations.