Allgrove syndrome in adulthood

A 35-year-old man with a past history of achalasia developed progressive sp astic tetraparesis, distal limb atrophy, dysarthria, and dysphagia. A clini cal diagnosis of amyotrophic lateral sclerosis (ALS) was considered before neurophysiological investigation, which disclosed a polyneuropathy and a pr olonged central conduction time. One year later, the patient developed dysa utonomic symptoms. Following confirmation of adrenal insufficiency, a diagn osis of Allgrove syndrome was made. This is a rare case, and we emphasize i ts clinical similarity with ALS. (C) 2001 John Wiley & Sons, Inc.