Case report: Treatable immune-mediated severe orthostatic hypotension in SARS-CoV-2 infection
We report a patient with autonomic dysfunction following acute SARS-CoV-2 infection, presenting progressively worsening severe orthostatic hypotension to the point where she could no longer sit or stand. The patient experienced a delay in diagnosis after an initial misdiagnosis of a functional neuro...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2024.1505727/full |
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| Summary: | We report a patient with autonomic dysfunction following acute SARS-CoV-2 infection, presenting progressively worsening severe orthostatic hypotension to the point where she could no longer sit or stand. The patient experienced a delay in diagnosis after an initial misdiagnosis of a functional neurological disorder. Persistent orthostatic symptoms prompted us to re-examine the diagnosis and explore other diagnostic tools, which ultimately allowed us to identify and treat severe immune-mediated orthostatic hypotension (OH). We identified autoantibodies (AAB) targeting the autonomic nervous system. Intravascular immunoglobulin therapy, along with early, specific multi-disciplinary rehabilitation, completely resolved the symptoms. Hard-to-assess patients are often penalized by suboptimal care due to the lack of a comprehensive patient history and physical examination, resulting in unnecessary and costly ancillary examinations that lead to delays in diagnosis or misdiagnoses. Furthermore, a lack of awareness of rare complications with new diseases may also hamper proper patient care. In the present case, this includes the wide range of SARS-CoV-2 infection manifestations, including immune-mediated autonomic complications. |
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| ISSN: | 1662-453X |