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Revision as of 08:51, 31 August 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Muneeb, MBBS [2] Synonyms and keywords: Holmes-Adie Syndrome; Syndrome, Holmes-Adie; Syndrome, Adie's; Syndrome, Adie; Poorly Reacting Pupil; Holmes Adie Syndrome; Pupil, Poorly Reacting; Adie's Syndrome; Poorly Reacting Pupils; Pupils, Poorly Reacting

Overview

Historical Perspective

[[Adie] syndrome]] was first discovered by William John Adie, a British neurologist, and Sir Gordon Morgan Holmes, an Irish neurologist in 1931. This syndrome was named after these 2 neurologists. ^[1]
In [year], the first [discovery] was developed by [scientist] to treat/diagnose [disease name].

Classification

[Disease name] may be classified according to [classification method] into [number] subtypes/groups:

[group1]
[group2]
[group3]

Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].

Pathophysiology

The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Causes

Most commonly the cause of Adie syndrome is unknown(idiopathic). Less common causes of adie syndrome include infections like HIV^[2], syphilis^[3], varicella, lyme's disease^[4], Human parvovirus-B19, autoimmune diseases like amyloidosis, sarcoidosis, guillain-barre syndrome, sjogren syndrome, polyarterities nodosa^[5], vogt-koyanagi-haraga disease^[6], ischemia caused by giant cell arteritis^[7], migraine^[8], lymphatoid granulomatosis, neuromuscular diseases like Lambert eaten syndrome^[9], tumors affecting the orbit or choroid^[10], orbital surgery^[11], cardiovascular diseases^[12], general anesthesia^[13]. ,anti-hu antibody^[14].

Differentiating [disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:

[Differential dx1]
[Differential dx2]
[Differential dx3]

Epidemiology and Demographics

The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].

Age

Patients of all age groups may develop [disease name].

[Disease name] is more commonly observed among patients aged [age range] years old.
[Disease name] is more commonly observed among [elderly patients/young patients/children].

Gender

[Disease name] affects men and women equally.

[Gender 1] are more commonly affected with [disease name] than [gender 2].
The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.

Race

There is no racial predilection for [disease name].

[Disease name] usually affects individuals of the [race 1] race.
[Race 2] individuals are less likely to develop [disease name].

Risk Factors

Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

Natural History, Complications and Prognosis

The majority of patients with [disease name] remain asymptomatic for [duration/years].
Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].

Diagnosis

Diagnostic Criteria

The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:

[criterion 1]
[criterion 2]
[criterion 3]
[criterion 4]

History and Symptoms

[Disease name] is usually asymptomatic.
Symptoms of [disease name] may include the following:

[symptom 1]
[symptom 2]
[symptom 3]
[symptom 4]
[symptom 5]
[symptom 6]

Physical Examination

Patients with [disease name] usually appear [general appearance].
Physical examination may be remarkable for:

[finding 1]
[finding 2]
[finding 3]
[finding 4]
[finding 5]
[finding 6]

Laboratory Findings

There are no specific laboratory findings associated with [disease name].

A [positive/negative] [test name] is diagnostic of [disease name].
An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].

Electrocardiogram

There are no ECG findings associated with [disease name].

OR

An ECG may be helpful in the diagnosis of [disease name]. Findings on an ECG suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

X-ray

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Echocardiography or Ultrasound

There are no echocardiography/ultrasound findings associated with [disease name].

OR

Echocardiography/ultrasound may be helpful in the diagnosis of [disease name]. Findings on an echocardiography/ultrasound suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no echocardiography/ultrasound findings associated with [disease name]. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

CT scan

There are no CT scan findings associated with [disease name].

OR

[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

MRI

There are no MRI findings associated with [disease name].

OR

[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

Other Imaging Findings

There are no other imaging findings associated with [disease name].

OR

[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

Other Diagnostic Studies

There are no other diagnostic studies associated with [disease name].

OR

[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].

Treatment

Medical Therapy

There is no treatment for [disease name]; the mainstay of therapy is supportive care.

The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
[Medical therapy 1] acts by [mechanism of action 1].
Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].

Surgery

Surgery is the mainstay of therapy for [disease name].
[Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
[Surgical procedure] can only be performed for patients with [disease stage] [disease name].

Prevention

There are no primary preventive measures available for [disease name].

Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].

Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].

References

↑ Thompson HS (1977). "Adie's syndrome: some new observations". Transactions of the American Ophthalmological Society. 75: 587–626. PMC 1311565. PMID 613531.
↑ Cerny R, Rozsypal H, Kozner P, Machala L (October 2010). "Bilateral Holmes-Adie syndrome as an early manifestation of the HIV neuropathy". Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 31 (5): 661–3. doi:10.1007/s10072-010-0355-9. PMID 20567990.
↑ Sakai T, Shikishima K, Mizobuchi T, Yoshida M, Kitahara K (2003). "Bilateral tonic pupils associated with neurosyphilis". Japanese Journal of Ophthalmology. 47 (4): 368–71. doi:10.1016/s0021-5155(03)00058-3. PMID 12842205.
↑ Stricker RB, Winger EE (March 2001). "Holmes-Adie syndrome and Lyme disease". Lancet (London, England). 357 (9258): 805. doi:10.1016/S0140-6736(05)71234-4. PMID 11254002.
↑ Bennett JL, Pelak VA, Mourelatos Z, Bird S, Galetta SL (1999). "Acute sensorimotor polyneuropathy with tonic pupils and an abduction deficit: an unusual presentation of polyarteritis nodosa". Survey of Ophthalmology. 43 (4): 341–4. doi:10.1016/s0039-6257(98)00047-2. PMID 10025516.
↑ Garza Leon M, Herrera-Jimenez IP, González-Madrigal PM (August 2014). "Complete Vogt-Koyanagi-Harada disease and Holmes-Adie syndrome: case report". Ocular Immunology and Inflammation. 22 (4): 336–40. doi:10.3109/09273948.2013.848906. PMID 24215593.
↑ Foroozan R, Buono LM, Savino PJ, Sergott RC (April 2003). "Tonic pupils from giant cell arteritis". The British Journal of Ophthalmology. 87 (4): 510–2. doi:10.1136/bjo.87.4.510. PMC 1771609. PMID 12642330.
↑ Purvin VA (March 1995). "Adie's tonic pupil secondary to migraine". Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 15 (1): 43–4. PMID 7780572.
↑ Wirtz PW, de Keizer RJ, de Visser M, Wintzen AR, Verschuuren JJ (March 2001). "Tonic pupils in Lambert-Eaton myasthenic syndrome". Muscle & Nerve. 24 (3): 444–5. doi:10.1002/1097-4598(200103)24:3<444::aid-mus1021>3.0.co;2-w. PMID 11353435.
↑ Goldstein SM, Liu GT, Edmond JC, Katowitz JA, Rorke LB (February 2002). "Orbital neural-glial hamartoma associated with a congenital tonic pupil". Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus. 6 (1): 54–5. doi:10.1067/mpa.2002.120171. PMID 11907481.
↑ Stromberg BV, Knibbe M (November 1988). "Anisocoria following reduction of bilateral orbital floor fractures". Annals of Plastic Surgery. 21 (5): 486–8. doi:10.1097/00000637-198811000-00016. PMID 3232939.
↑ Guaraldi P, Mathias CJ (September 2011). "Progression of cardiovascular autonomic dysfunction in Holmes-Adie syndrome". Journal of Neurology, Neurosurgery, and Psychiatry. 82 (9): 1046–9. doi:10.1136/jnnp.2009.195917. PMID 20562402.
↑ Kobayashi M, Takenami T, Kimotsuki H, Mukuno K, Hoka S (February 2008). "Adie syndrome associated with general anesthesia". Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 55 (2): 130–1. doi:10.1007/BF03016329. PMID 18245077.
↑ Zhang L, Luo S, Jin H, Lv X, Chen J (2019). "Anti-Hu Antibody-Associated Adie's Pupil and Paraneoplastic Sensorimotor Polyneuropathy Caused by Primary Mediastinal Small Cell Carcinoma". Frontiers in Neurology. 10: 1236. doi:10.3389/fneur.2019.01236. PMC 6901962 Check |pmc= value (help). PMID 31849812.

Template:WS Template:WH

[pmid613531-1] Thompson HS (1977). "Adie's syndrome: some new observations". Transactions of the American Ophthalmological Society. 75: 587–626. PMC 1311565. PMID 613531.

[pmid20567990-2] Cerny R, Rozsypal H, Kozner P, Machala L (October 2010). "Bilateral Holmes-Adie syndrome as an early manifestation of the HIV neuropathy". Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 31 (5): 661–3. doi:10.1007/s10072-010-0355-9. PMID 20567990.

[pmid12842205-3] Sakai T, Shikishima K, Mizobuchi T, Yoshida M, Kitahara K (2003). "Bilateral tonic pupils associated with neurosyphilis". Japanese Journal of Ophthalmology. 47 (4): 368–71. doi:10.1016/s0021-5155(03)00058-3. PMID 12842205.

[pmid11254002-4] Stricker RB, Winger EE (March 2001). "Holmes-Adie syndrome and Lyme disease". Lancet (London, England). 357 (9258): 805. doi:10.1016/S0140-6736(05)71234-4. PMID 11254002.

[pmid10025516-5] Bennett JL, Pelak VA, Mourelatos Z, Bird S, Galetta SL (1999). "Acute sensorimotor polyneuropathy with tonic pupils and an abduction deficit: an unusual presentation of polyarteritis nodosa". Survey of Ophthalmology. 43 (4): 341–4. doi:10.1016/s0039-6257(98)00047-2. PMID 10025516.

[pmid24215593-6] Garza Leon M, Herrera-Jimenez IP, González-Madrigal PM (August 2014). "Complete Vogt-Koyanagi-Harada disease and Holmes-Adie syndrome: case report". Ocular Immunology and Inflammation. 22 (4): 336–40. doi:10.3109/09273948.2013.848906. PMID 24215593.

[pmid12642330-7] Foroozan R, Buono LM, Savino PJ, Sergott RC (April 2003). "Tonic pupils from giant cell arteritis". The British Journal of Ophthalmology. 87 (4): 510–2. doi:10.1136/bjo.87.4.510. PMC 1771609. PMID 12642330.

[pmid7780572-8] Purvin VA (March 1995). "Adie's tonic pupil secondary to migraine". Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society. 15 (1): 43–4. PMID 7780572.

[pmid11353435-9] Wirtz PW, de Keizer RJ, de Visser M, Wintzen AR, Verschuuren JJ (March 2001). "Tonic pupils in Lambert-Eaton myasthenic syndrome". Muscle & Nerve. 24 (3): 444–5. doi:10.1002/1097-4598(200103)24:3<444::aid-mus1021>3.0.co;2-w. PMID 11353435.

[pmid11907481-10] Goldstein SM, Liu GT, Edmond JC, Katowitz JA, Rorke LB (February 2002). "Orbital neural-glial hamartoma associated with a congenital tonic pupil". Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus. 6 (1): 54–5. doi:10.1067/mpa.2002.120171. PMID 11907481.

[pmid3232939-11] Stromberg BV, Knibbe M (November 1988). "Anisocoria following reduction of bilateral orbital floor fractures". Annals of Plastic Surgery. 21 (5): 486–8. doi:10.1097/00000637-198811000-00016. PMID 3232939.

[pmid20562402-12] Guaraldi P, Mathias CJ (September 2011). "Progression of cardiovascular autonomic dysfunction in Holmes-Adie syndrome". Journal of Neurology, Neurosurgery, and Psychiatry. 82 (9): 1046–9. doi:10.1136/jnnp.2009.195917. PMID 20562402.

[pmid18245077-13] Kobayashi M, Takenami T, Kimotsuki H, Mukuno K, Hoka S (February 2008). "Adie syndrome associated with general anesthesia". Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 55 (2): 130–1. doi:10.1007/BF03016329. PMID 18245077.

[pmid31849812-14] Zhang L, Luo S, Jin H, Lv X, Chen J (2019). "Anti-Hu Antibody-Associated Adie's Pupil and Paraneoplastic Sensorimotor Polyneuropathy Caused by Primary Mediastinal Small Cell Carcinoma". Frontiers in Neurology. 10: 1236. doi:10.3389/fneur.2019.01236. PMC 6901962 Check |pmc= value (help). PMID 31849812.

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 ==Causes==
-Most commonly the cause of [[Adie syndrome]] is unknown([[idiopathic]]). Less common causes of [[adie syndrome]] include [[infections]] like [[HIV]], [[syphilis]], [[varicella]], [[lyme's disease]], [[Human parvovirus-B19]], [[autoimmune diseases]] like [[amyloidosis]], [[sarcoidosis]], [[guillain-barre syndrome]], [[sjogren syndrome]], [[polyarterities nodosa]], [[vogt-koyanagi-haraga disease]], [[ischemia]] caused by [[giant cell arteritis]], [[migraine]], [[lymphatoid granulomatosis]], [[neuromuscular diseases]] like [[Lambert eaten syndrome]], [[tumors]] affecting the [[orbit]] or [[choroid]], [[orbital surgery]], [[cardiovascular diseases]], [[anesthesia]].
+Most commonly the cause of [[Adie syndrome]] is unknown([[idiopathic]]). Less common causes of [[adie syndrome]] include [[infections]] like [[HIV]]<ref name="pmid20567990">{{cite journal |vauthors=Cerny R, Rozsypal H, Kozner P, Machala L |title=Bilateral Holmes-Adie syndrome as an early manifestation of the HIV neuropathy |journal=Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology |volume=31 |issue=5 |pages=661–3 |date=October 2010 |pmid=20567990 |doi=10.1007/s10072-010-0355-9 |url= |issn=}}</ref>, [[syphilis]]<ref name="pmid12842205">{{cite journal |vauthors=Sakai T, Shikishima K, Mizobuchi T, Yoshida M, Kitahara K |title=Bilateral tonic pupils associated with neurosyphilis |journal=Japanese Journal of Ophthalmology |volume=47 |issue=4 |pages=368–71 |date=2003 |pmid=12842205 |doi=10.1016/s0021-5155(03)00058-3 |url= |issn=}}</ref>, [[varicella]], [[lyme's disease]]<ref name="pmid11254002">{{cite journal |vauthors=Stricker RB, Winger EE |title=Holmes-Adie syndrome and Lyme disease |journal=Lancet (London, England) |volume=357 |issue=9258 |pages=805 |date=March 2001 |pmid=11254002 |doi=10.1016/S0140-6736(05)71234-4 |url= |issn=}}</ref>, [[Human parvovirus-B19]], [[autoimmune diseases]] like [[amyloidosis]], [[sarcoidosis]], [[guillain-barre syndrome]], [[sjogren syndrome]], [[polyarterities nodosa]]<ref name="pmid10025516">{{cite journal |vauthors=Bennett JL, Pelak VA, Mourelatos Z, Bird S, Galetta SL |title=Acute sensorimotor polyneuropathy with tonic pupils and an abduction deficit: an unusual presentation of polyarteritis nodosa |journal=Survey of Ophthalmology |volume=43 |issue=4 |pages=341–4 |date=1999 |pmid=10025516 |doi=10.1016/s0039-6257(98)00047-2 |url= |issn=}}</ref>, [[vogt-koyanagi-haraga disease]]<ref name="pmid24215593">{{cite journal |vauthors=Garza Leon M, Herrera-Jimenez IP, González-Madrigal PM |title=Complete Vogt-Koyanagi-Harada disease and Holmes-Adie syndrome: case report |journal=Ocular Immunology and Inflammation |volume=22 |issue=4 |pages=336–40 |date=August 2014 |pmid=24215593 |doi=10.3109/09273948.2013.848906 |url= |issn=}}</ref>, [[ischemia]] caused by [[giant cell arteritis]]<ref name="pmid12642330">{{cite journal |vauthors=Foroozan R, Buono LM, Savino PJ, Sergott RC |title=Tonic pupils from giant cell arteritis |journal=The British Journal of Ophthalmology |volume=87 |issue=4 |pages=510–2 |date=April 2003 |pmid=12642330 |pmc=1771609 |doi=10.1136/bjo.87.4.510 |url= |issn=}}</ref>, [[migraine]]<ref name="pmid7780572">{{cite journal |vauthors=Purvin VA |title=Adie's tonic pupil secondary to migraine |journal=Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society |volume=15 |issue=1 |pages=43–4 |date=March 1995 |pmid=7780572 |doi= |url= |issn=}}</ref>, [[lymphatoid granulomatosis]], [[neuromuscular diseases]] like [[Lambert eaten syndrome]]<ref name="pmid11353435">{{cite journal |vauthors=Wirtz PW, de Keizer RJ, de Visser M, Wintzen AR, Verschuuren JJ |title=Tonic pupils in Lambert-Eaton myasthenic syndrome |journal=Muscle & Nerve |volume=24 |issue=3 |pages=444–5 |date=March 2001 |pmid=11353435 |doi=10.1002/1097-4598(200103)24:3<444::aid-mus1021>3.0.co;2-w |url= |issn=}}</ref>, [[tumors]] affecting the [[orbit]] or [[choroid]]<ref name="pmid11907481">{{cite journal |vauthors=Goldstein SM, Liu GT, Edmond JC, Katowitz JA, Rorke LB |title=Orbital neural-glial hamartoma associated with a congenital tonic pupil |journal=Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus |volume=6 |issue=1 |pages=54–5 |date=February 2002 |pmid=11907481 |doi=10.1067/mpa.2002.120171 |url= |issn=}}</ref>, [[orbital surgery]]<ref name="pmid3232939">{{cite journal |vauthors=Stromberg BV, Knibbe M |title=Anisocoria following reduction of bilateral orbital floor fractures |journal=Annals of Plastic Surgery |volume=21 |issue=5 |pages=486–8 |date=November 1988 |pmid=3232939 |doi=10.1097/00000637-198811000-00016 |url= |issn=}}</ref>, [[cardiovascular diseases]]<ref name="pmid20562402">{{cite journal |vauthors=Guaraldi P, Mathias CJ |title=Progression of cardiovascular autonomic dysfunction in Holmes-Adie syndrome |journal=Journal of Neurology, Neurosurgery, and Psychiatry |volume=82 |issue=9 |pages=1046–9 |date=September 2011 |pmid=20562402 |doi=10.1136/jnnp.2009.195917 |url= |issn=}}</ref>, [[general anesthesia]]<ref name="pmid18245077">{{cite journal |vauthors=Kobayashi M, Takenami T, Kimotsuki H, Mukuno K, Hoka S |title=Adie syndrome associated with general anesthesia |journal=Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie |volume=55 |issue=2 |pages=130–1 |date=February 2008 |pmid=18245077 |doi=10.1007/BF03016329 |url= |issn=}}</ref>. ,[[anti-hu antibody]]<ref name="pmid31849812">{{cite journal |vauthors=Zhang L, Luo S, Jin H, Lv X, Chen J |title=Anti-Hu Antibody-Associated Adie's Pupil and Paraneoplastic Sensorimotor Polyneuropathy Caused by Primary Mediastinal Small Cell Carcinoma |journal=Frontiers in Neurology |volume=10 |issue= |pages=1236 |date=2019 |pmid=31849812 |pmc=6901962 |doi=10.3389/fneur.2019.01236 |url= |issn=}}</ref>.
 ==Differentiating [disease name] from other Diseases==