Evidence map›Paper›PMID 39840012›Full record

ArticleFrontiers in neuroscience2024

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

Kenji Theiler, Maroussia Bronchain, Eric Grouzmann, Serge Duflon, Lorenz Hirt, Renaud Du Pasquier, Gérard Waeber, Grégoire Wuerzner, Karin Diserens, Julien F Bally

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Frontiers in neuroscience, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Kenji TheilerService of Nephrology and Hypertension, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Maroussia BronchainService of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Eric GrouzmannLaboratory of Catecholamines and Peptides, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Serge DuflonService of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Lorenz HirtService of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Renaud Du PasquierService of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Gérard WaeberDepartment of Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Grégoire WuerznerService of Nephrology and Hypertension, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Karin Diserens *Acute Neurorehabilitation Unit, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
Julien F Bally *Service of Neurology, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

autoantibodiesCOVID-19dysautonomiaintravascular immunoglobulin therapyorthostatic hypotensionrehabilitation

Identifiers

PMID39840012
PMCPMC11746903

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.