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A 44-Year-Old Male with Subacute Onset of Syncope 

A 44-Year-Old Male with Subacute Onset of Syncope
A 44-Year-Old Male with Subacute Onset of Syncope

Jeffrey A. Cohen

, Justin J. Mowchun

, Victoria H. Lawson

, and Nathaniel M. Robbins

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date: 31 July 2021

Syncope in a patient with orthostatic hypotension (OH) may indicate autonomic dysfunction. The definition of OH is presented. Clinical features of parasympathetic and sympathetic function are discussed. The differential of acute autonomic dysfunction includes a number of conditions. An autoimmune etiology may occur autoimmune autonomic ganglionopathy. Serologic testing can assist in this diagnosis. If autoimmune immune modulating therapies may be indicated. Autonomic neuropathy may be a paraneoplastuc syndrome. Autonomic testing can also help with documenting autonomic neuropathy as well as the whether the defects are predominately parasympathetic or sympathetic. Amyloid should be considered as should diabetes but both have a more chronic course. An appropriate tissue biopsy with Congo Red staining can help to confirm the diagnosis of amyloid.

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