Christy L Spalink1, Erin Barnes1, Jose-Alberto Palma1, Lucy Norcliffe-Kaufmann1, Horacio Kaufmann2. 1. Department of Neurology, Dysautonomia Center, New York University School of Medicine, New York, NY, USA. 2. Department of Neurology, Dysautonomia Center, New York University School of Medicine, New York, NY, USA. horacio.kaufmann@nyumc.org.
Abstract
PURPOSE: To report the use of intranasal dexmedetomidine, an α2-adrenergic agonist for the acute treatment of refractory adrenergic crisis in patients with familial dysautonomia. METHODS: Case series. RESULTS: Three patients with genetically confirmed familial dysautonomia (case 1: 20-year-old male; case 2: 43-year-old male; case 3: 26-year-old female) received intranasal dexmedetomidine 2 mcg/kg, half of the dose in each nostril, for the acute treatment of adrenergic crisis. Within 8-17 min of administering the intranasal dose, the adrenergic crisis symptoms abated, and blood pressure and heart rate returned to pre-crises values. Adrenergic crises eventually resumed, and all three patients required hospitalization for investigation of the cause of the crises. CONCLUSIONS: Intranasal dexmedetomidine is a feasible and safe acute treatment for adrenergic crisis in patients with familial dysautonomia. Further controlled studies are required to confirm the safety and efficacy in this population.
PURPOSE: To report the use of intranasal dexmedetomidine, an α2-adrenergic agonist for the acute treatment of refractory adrenergic crisis in patients with familial dysautonomia. METHODS: Case series. RESULTS: Three patients with genetically confirmed familial dysautonomia (case 1: 20-year-old male; case 2: 43-year-old male; case 3: 26-year-old female) received intranasal dexmedetomidine 2 mcg/kg, half of the dose in each nostril, for the acute treatment of adrenergic crisis. Within 8-17 min of administering the intranasal dose, the adrenergic crisis symptoms abated, and blood pressure and heart rate returned to pre-crises values. Adrenergic crises eventually resumed, and all three patients required hospitalization for investigation of the cause of the crises. CONCLUSIONS: Intranasal dexmedetomidine is a feasible and safe acute treatment for adrenergic crisis in patients with familial dysautonomia. Further controlled studies are required to confirm the safety and efficacy in this population.
Authors: Ryan C Dillon; Jose-Alberto Palma; Christy L Spalink; Diana Altshuler; Lucy Norcliffe-Kaufmann; David Fridman; John Papadopoulos; Horacio Kaufmann Journal: Clin Auton Res Date: 2016-10-17 Impact factor: 4.435
Authors: Mikhail Kazachkov; Jose-Alberto Palma; Lucy Norcliffe-Kaufmann; Bat-El Bar-Aluma; Christy L Spalink; Erin P Barnes; Nancy E Amoroso; Stamatela M Balou; Shay Bess; Arun Chopra; Rany Condos; Ori Efrati; Kathryn Fitzgerald; David Fridman; Ronald M Goldenberg; Ayelet Goldhaber; David A Kaufman; Sanjeev V Kothare; Jeremiah Levine; Joseph Levy; Anthony S Lubinsky; Channa Maayan; Libia C Moy; Pedro J Rivera; Alcibiades J Rodriguez; Gil Sokol; Mark F Sloane; Tina Tan; Horacio Kaufmann Journal: Respir Med Date: 2018-06-21 Impact factor: 3.415
Authors: Italo Biaggioni; Cyndya A Shibao; André Diedrich; James A S Muldowney; Cheryl L Laffer; Jens Jordan Journal: J Am Coll Cardiol Date: 2019-12-10 Impact factor: 24.094
Authors: Annette Lischka; Petra Lassuthova; Arman Çakar; Christopher J Record; Jonas Van Lent; Jonathan Baets; Maike F Dohrn; Jan Senderek; Angelika Lampert; David L Bennett; John N Wood; Vincent Timmerman; Thorsten Hornemann; Michaela Auer-Grumbach; Yesim Parman; Christian A Hübner; Miriam Elbracht; Katja Eggermann; C Geoffrey Woods; James J Cox; Mary M Reilly; Ingo Kurth Journal: Nat Rev Dis Primers Date: 2022-06-16 Impact factor: 65.038