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Autoimmunity in Syndromes of Orthostatic Intolerance: An Updated Review
Journal article   Open access   Peer reviewed

Autoimmunity in Syndromes of Orthostatic Intolerance: An Updated Review

Clarissa Pena, Abdelmoniem Moustafa, Abdel-Rhman Mohamed and Blair Grubb
Journal of personalized medicine, Vol.14(4), p.435
04/01/2024
DOI: 10.3390/jpm14040435
PMCID: PMC11051445
PMID: 38673062
url
https://doi.org/10.3390/jpm14040435View
Published (Version of record) Open Access

Abstract

Orthostatic intolerance is a broad term that represents a spectrum of dysautonomic disorders, including postural orthostatic tachycardia syndrome (POTS) and orthostatic hypotension (OH), as manifestations of severe autonomic failure. While the etiology of orthostatic intolerance has not yet fully been uncovered, it has been associated with multiple underlying pathological processes, including peripheral neuropathy, altered renin-aldosterone levels, hypovolemia, and autoimmune processes. Studies have implicated adrenergic, cholinergic, and angiotensin II type I autoantibodies in the pathogenesis of orthostatic intolerance. Several case series have demonstrated that immunomodulation therapy resulted in favorable outcomes, improving autonomic symptoms in POTS and OH. In this review, we highlight the contemporary literature detailing the association of autoimmunity with POTS and OH.
General & Internal Medicine Health Care Sciences & Services Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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