National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Triple A syndrome

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My 15 year old daughter was recently diagnosed with triple A syndrome. Is there anything that can be done about her abnormal sweating? We have tried various types of treatments and so far none have worked.
Many of the features of triple A syndrome, including abnormally increased sweating (hyperhidrosis), are caused by dysfunction of the autonomic nervous system (dysautonomia), which controls involuntary body processes.[1] In most cases, the goal of treating secondary hyperhidrosis (caused by a primary underlying condition) is to treat the underlying condition; unfortunately, there is no cure for dysautonomia so only symptomatic treatment may be possible.[2]

Most of the treatments for hyperhidrosis discussed in the medical literature involve primary and/or focal hyperhidrosis, which is often idiopathic (of unknown cause). Treatment options for these have included medications, antiperspirants, iontophoresis, Botulinum toxin type A (Botox), endoscopic thoracic sympathectomy (ETS), and surgical intervention.[3] Several studies have mentioned that generalized hyperhidrosis may optionally be treated with systemic anticholinergic agents,[4] which are used to prevent the stimulation of sweat glands.[3] However, the associated adverse effects have somewhat limited their use.[4]

Antidepressant drugs such as amitriptyline and paroxetine, as well as antihypertensive drugs (blood pressure medications) such as beta blockers, calcium channel antagonists, alpha antagonists, and alpha-2 agonists have been described in single case reports as only slightly to moderately effective.[5]
Last updated: 9/24/2015

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  1. Triple A syndrome. Genetics Home Reference. February 2010; http://ghr.nlm.nih.gov/condition/triple-a-syndrome. Accessed 9/24/2015.
  2. NINDS Dysautonomia Information Page. National Institute of Neurological Disorders and Stroke. June 16, 2010; http://www.ninds.nih.gov/disorders/dysautonomia/dysautonomia.htm#Is_there_any_treatment. Accessed 2/10/2011.
  3. Hyperhidrosis. American Academy of Dermatology. 2010; http://www.aad.org/public/publications/pamphlets/common_hyperhidrosis.html. Accessed 2/10/2011.
  4. M.A. Callejas, R. Grimalt and E. Cladellasa. Hyperhidrosis Update. Actas Dermo-Sifiliográficas. 2010; 101(2):110-118.
  5. Tanja Schlereth, Marianne Dieterich, and Frank Birklein. Hyperhidrosis—Causes and Treatment of Enhanced Sweating. Deutsches Arzteblatt International. January 2009; 106(3):32-37. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2695293/?tool=pubmed. Accessed 9/24/2015.