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A case of acute reversible pure adrenergic failure
Kurt Kimpinski1, Colleen T Ives
1Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Department of Clinical Neurological Sciences, University Hospital, London Health Sciences Centre, London, Ontario, Canada.
Abstract:
A 14-year-old man presented 2 weeks after a viral pharyngitis with acute onset orthostasis and a pattern of pure adrenergic failure with neurogenic orthostatic hypotension that responded to intravenous immunoglobulin. The patient returned to his normal daily activities with resolution of his orthostatic hypotension and return of cardiac adrenergic responses as demonstrated by the Valsalva maneuver. Here we discuss the clinical and laboratory features of pure adrenergic failure, the more common etiologies, and the potential treatment options, with a focus on those presentations presumed to be autoimmune or inflammatory.
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