Role of autoimmunity in the etiopathogenesis of Ross syndrome

Abstract Ross syndrome is a rare clinical entity that manifests classically with a triad of segmental anhidrosis, tonic pupil, and hyporeflexia. Here, we present a case of Ross syndrome in a university-going female in her early twenties with a history of hypothyroidism for 5 years. She has complained of insidious onset and progressive anhidrosis on the right side of her body for 7 years. On evaluation, we found her to have autoimmune thyroiditis with elevated serum antithyroid peroxidase antibody. The antinuclear antibody titer was also raised significantly, suggesting a possible autoimmune etiology. In our case, we reiterate the need for autoimmune testing in cases of Ross syndrome and further research on the effectiveness of immunomodulators for treatment.