S Blitshteyn1. 1. Department of Neurology, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY, USA.
Abstract
BACKGROUND AND PURPOSE: Postural tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that may have an autoimmune etiology. METHODS: Six patients who developed new onset POTS 6 days to 2 months following human papillomavirus vaccination are reported. RESULTS: Three patients also had neurocardiogenic syncope, and three patients were diagnosed with possible small fiber neuropathy. Symptoms in all patients improved over 3 years with pharmacotherapy and non-pharmacological measures but residual symptoms persisted. Molecular mimicry with formation of cross-reacting autoantibodies to the potential targets of the autonomic ganglia, neurons, cardiac proteins or vascular receptors is considered as a possible pathogenesis of new onset POTS after immunization. CONCLUSION: Correct diagnosis of POTS and awareness that POTS may occur after vaccination in young women is essential for prompt and effective management of this condition.
BACKGROUND AND PURPOSE: Postural tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that may have an autoimmune etiology. METHODS: Six patients who developed new onset POTS 6 days to 2 months following human papillomavirus vaccination are reported. RESULTS: Three patients also had neurocardiogenic syncope, and three patients were diagnosed with possible small fiber neuropathy. Symptoms in all patients improved over 3 years with pharmacotherapy and non-pharmacological measures but residual symptoms persisted. Molecular mimicry with formation of cross-reacting autoantibodies to the potential targets of the autonomic ganglia, neurons, cardiac proteins or vascular receptors is considered as a possible pathogenesis of new onset POTS after immunization. CONCLUSION: Correct diagnosis of POTS and awareness that POTS may occur after vaccination in young women is essential for prompt and effective management of this condition.
Keywords:
disorders of the autonomic nervous system; human papillomavirus vaccination; neuropathy; postural tachycardia syndrome; small fibers; vaccination
Authors: Geneviève Rail; Luisa Molino; Caroline Fusco; Moss Edward Norman; LeAnne Petherick; Jessica Polzer; Fiona Moola; Mary Bryson Journal: Can J Public Health Date: 2018-08-03
Authors: Alexandru Barboi; Christopher H Gibbons; Felicia Axelrod; Eduardo E Benarroch; Italo Biaggioni; Mark W Chapleau; Gisela Chelimsky; Thomas Chelimsky; William P Cheshire; Victoria E Claydon; Roy Freeman; David S Goldstein; Michael J Joyner; Horacio Kaufmann; Phillip A Low; Lucy Norcliffe-Kaufmann; David Robertson; Cyndya A Shibao; Wolfgang Singer; Howard Snapper; Steven Vernino; Satish R Raj Journal: Clin Auton Res Date: 2019-09-02 Impact factor: 4.435