Acute onset autonomic dysfunction and orthostatic syncope as an early manifestation of HIV infection
To the Editors
Neurological complications, including autonomic disturbances, may occur as a consequence of various infectious diseases , including human immunodeficiency virus (HIV) infection. However, in the case of HIV infection, neurologic complications tend to occur at later stages of the disease [2, 3, 4]. Herein, we describe a patient with new onset symptomatic orthostatic hypotension (OH) and laboratory evidence of autonomic dysfunction as an early manifestation of HIV infection.
A 47-year-old previously healthy man presented with three episodes of transient loss of consciousness (TLOC) preceded by blurry vision and lightheadedness. The TLOC episodes began abruptly within the previous few weeks, and each was associated with postural change or while climbing stairs. At approximately the same time, he had had diarrhea which resolved, but OH persisted, and, in addition, he experienced muscle aches and headaches. Further, he noted a 9 kg weight loss over several weeks. Prior to...