Case report: Treatable immune-mediated severe orthostatic hypotension in SARS-CoV-2 infection.

Details

Serval ID
serval:BIB_CA90516B0D5A
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Case report: Treatable immune-mediated severe orthostatic hypotension in SARS-CoV-2 infection.
Journal
Frontiers in neuroscience
Author(s)
Theiler K., Bronchain M., Grouzmann E., Duflon S., Hirt L., Du Pasquier R., Waeber G., Wuerzner G., Diserens K., Bally J.F.
ISSN
1662-4548 (Print)
ISSN-L
1662-453X
Publication state
Published
Issued date
2024
Peer-reviewed
Oui
Volume
18
Pages
1505727
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Abstract
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.
Keywords
COVID-19, autoantibodies, dysautonomia, intravascular immunoglobulin therapy, orthostatic hypotension, rehabilitation
Pubmed
Open Access
Yes
Create date
24/01/2025 15:00
Last modification date
25/01/2025 7:04
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