Autonomic dysfunction may occur as a paraneoplastic syndrome that can appear several years prior to recognition of the underlying tumor.
Clinical features of the autonomic dysfunction:
(1) intestinal pseudo-obstruction
(2) other gastrointestinal dysmotility
(3) orthostatic hypotension
(4) cardiac arrhythmias
(5) erectile dysfunction (in males)
(6) dry mouth
(7) anhidrosis
(8) sphincter dysfunction
Autonomic dysfunction may accompany Lambert-Eaton Myasthenic Syndrome (LEMS).
Tumors that may be associated with paraneoplastic autonomic dysfunction:
(1) small cell lung cancer (SCLC) or carcinoid tumor of the lung
(2) pancreatic cancer
(3) testicular cancer
(4) Hodgkin's disease
A patient with paraneoplastic autonomic dysfunction should be screened for:
(1) anti-Hu antibodies
(2) antibodies to the neuronal nicotinic receptor
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Specialty: Neurology, Hematology Oncology
