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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