Two cases of pure progressive autonomic failure (PAF) are presented. A
postmortem study of one case (case 2) showed a pathology resembling t
hat of Parkinson's disease. Marked cell loss was noted in the substant
ia nigra, nucleus ceruleus, and intermediolateral column of the spinal
cord, while cell loss in the sympathetic ganglion was not remarkable.
This case may be an exceptionally rare case of late-onset PAF in whic
h autonomic failure was mainly ascribed to preganglionic (and central)
pathology, although autonomic function tests suggested postganglionic
sympathetic disorder in both cases.