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

• DOI: 10.3389/fnins.2024.1505727
• Publication Date: 2025-01-07T07:12:02Z
• Authors: Kenji Theiler; Maroussia Bronchain; Eric Grouzmann; Serge Duflon; Lorenz Hirt; Renaud Du Pasquier; Gérard Waeber; Grégoire Wuerzner; Karin Diserens; Julien F. Bally
• Keywords: Dysautonomia; Pure autonomic failure

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 experienced delay in diagnosis after an initial misdiagnosis of functional neurological disorder. Persistent symptoms prompted us re-examine and explore other diagnostic tools, which ultimately allowed identify treat immune-mediated (OH). identified autoantibodies (AAB) targeting nervous system. Intravascular immunoglobulin therapy, along early, specific multi-disciplinary rehabilitation, completely resolved symptoms. Hard-to-assess patients are often penalized by suboptimal care due lack comprehensive history physical examination, resulting unnecessary costly ancillary examinations that lead delays misdiagnoses. Furthermore, awareness rare complications new diseases may also hamper proper care. In present case, this includes wide range infection manifestations, including complications.