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Hypertensive Crisis with Vasogenic Cerebral Edema Induced by Droxidopa in a Patient with Pure Autonomic Failure

  • By

  • Min-Ku Kim

  • Sung-Sik Kim

  • Jong-Gyu Baek

  • August 20, 2026

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  • 1

    A 60-year-old female with advanced pure autonomic failure experienced a hypertensive crisis after starting low-dose droxidopa.

  • 2

    Droxidopa, commonly used for neurogenic orthostatic hypotension, can cause severe hypertensive complications even at low doses.

  • 3

    The patient exhibited significant blood pressure lability and supine hypertension prior to droxidopa treatment.

  • 4

    Emergency evaluation revealed elevated blood pressure and cerebral edema, confirmed by brain MRI showing multifocal lesions.

  • 5

    This case highlights the need for careful monitoring and dose titration of droxidopa in patients with advanced autonomic dysfunction.

Original Source(s)

Hypertensive emergency with vasogenic cerebral edema following droxidopa initiation in pure autonomic failure

  • by Min-Ku Kim, Sung-Sik Kim, Jong-Gyu Baek

  • August 20, 2026

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