SVOA Neurology

Vibhor Upadhyay^1*, Pooja Tripathi², Anup Kumar Thacker³

¹Senior consultant, Neurology, Medanta Hospital, Lucknow, India.

²Assistant Professor, Neurology, RMLIMS, Lucknow, India.

³Director, Neurology department, Medanta Hospital, Lucknow, India.

*Corresponding Author: Vibhor Upadhyay, Senior consultant, Neurology, Medanta Hospital, Lucknow, India.

DOI: https://doi.org/10.58624/SVOANE.2026.07.020

Received: May 28, 2026

Published: July 08, 2026

Citation: Upadhyay V, Tripathi P, Thacker AK. Autonomic Dysfunction as a Paraneoplastic Syndrome in Hodgkin's Lymphoma: A Case Report. SVOA Neurology 2026, 7:4, 139-142. doi.org/10.58624/SVOANE.2026.07.020

Abstract

Hodgkin's lymphoma is a B-cell malignancy of the lymphatic system characterized histologically by the presence of Reed-Sternberg cells. While paraneoplastic syndromes are known complications of malignancy, autonomic dysfunction as an initial and primary presentation is extremely rare in the context of Hodgkin's lymphoma. We report a case of an 82-year-old male presenting with a three-month history of progressive autonomic dysfunction symptoms, including severe orthostatic hypotension, anhidrosis, gastrointestinal disturbances, and gait instability with recurrent falls. Notably, the patient exhibited no cognitive decline. Initial differential diagnoses included rapidly progressive extrapyramidal syndromes; however, extensive workup including cerebrospinal fluid analysis and paraneoplastic and autoimmune panels yielded negative results. Whole-body Positron Emission Tomography (PET) scanning subsequently revealed multiple enlarged generalized lymphadenopathies. Biopsy confirmed the diagnosis of Hodgkin's lymphoma. This case underscores the critical importance of considering lymphoproliferative disorders in the differential diagnosis of unexplained subacute autonomic dysfunction, particularly in the elderly population.

Keywords: Hodgkin's lymphoma, Autonomic dysfunction, Paraneoplastic syndrome, Orthostatic hypotension, Dysautonomia.