A case report of pediatric paraneoplastic dysautonomia

Katherine Harer*, Jennifer Mann, Nicole Muhlbauer, Jennifer Welch, Brian Alverson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


We present the case of a 16-year-old girl who presented with severe refractory orthostatic hypotension secondary to pandysautonomia. Initially, she was treated for Guillain-Barré syndrome given clinical symptoms and increased protein on cerebrospinal fluid, but the severity of symptoms and lack of response to intravenous immunoglobulin prompted further evaluation for an autoimmune etiology. She was ultimately diagnosed with paraneoplastic neuropathy secondary to Hodgkin lymphoma. Paraneoplastic neurologic phenomena are rare, occurring in just 0.01% of cancers, and prompt recognition is crucial for initiating appropriate therapy. Rapid progression of severe disabling symptoms should raise suspicion for an underlying malignancy. The patient had limited response to splanchnic vasoconstrictors in addition to -agonists, anticholinergics, and mineralocorticoids until initiation of modified Hodgkin lymphoma directed chemotherapy plus rituximab.

Original languageEnglish (US)
Pages (from-to)E742-E744
JournalPediatric emergency care
Issue number12
StatePublished - Dec 2020
Externally publishedYes


  • Guillain-Barré syndrome
  • Hodgkin lymphoma
  • orthostatic hypotension
  • pandysautonomia
  • paraneoplastic neuropathy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine


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