Acute autonomic neuropathy associated with a high serum bradykinin level and positive anti-nuclear and anti-DNA antibodies titers.

A hypotensive 37-year-old man developed the problems of impotence, lack of sweating, orthostatic hypotension, and convulsive syncopal attack. His blood pressure fell to 53 mmHg systolic following bed-tilting from 30 to 60 degrees, but his heart rate remained constant which indicated a diagnosis of acute autonomic neuropathy. With the tilting test, a decrease in serum catecholamine levels and an increase in bradykinin levels were observed. Four months after admission, anti-nuclear antibody, anti-DNA antibody, and the LE test became positive. The acute autonomic neuropathy appeared to be associated with SLE, and the hyperbradykinism, consequent on orthostatic hypotension.