Nussinson E.; Hager, H.; Samara, M.; Bar-Nathan, N.; Siplovich, L.Journal of Pediatric Gastroenterology and Nutrition: March-April 1988 Case Report: PDF Only Free Abstract Summary Three of five siblings were evaluated because of dysphagia and failure to thrive. Radiologic and manometric studies were consistent with achalasia of the cardia. All of these siblings had deficient tear production. This report documents the unusual association of familial achalasia and deficient tear production, which is probably an autosomal recessive inherited syndrome. © Lippincott-Raven Publishers.