Jump to comment:
- Page navigation anchor for RE: Practical Approaches While POTS Science EmergesRE: Practical Approaches While POTS Science Emerges
Only a few years ago, the concept of postural orthostatic tachycardia syndrome (POTS) as detailed by Raj et al. was a considerably debated entity.(1) There is now a more consistent recognition, and hence credibility, for this spectral illness. As such, and without a more specific diagnostic test(s), clinical diagnosis remains paramount, but confusion will undoubtedly reign given the heterogeneity of the disease spectrum. Although POTS is said to be a chronic disease, the chronicity aspect is mainly imprinted by the definition parameters so claimed, like the general diagnosis itself as coined by many learned groups. Recognizing subgroups of POTS may prove valuable to better understand the potential for a multiplicity of causations if they exist.
Show More
As discussed in the review, many patients have a picture of dysautonomia with variable intensity. Indeed there is recognition of symptoms and signs that potentially overlap with non-clonal mast cell activation disorder and autoimmune/inflammatory syndrome induced by adjuvants.(2) Dysautonomia and small fibre neuropathy are also gaining more attention as outcomes for some similar pathological processes.(3) It is tempting to speculate on how POTS may emerge as part of the latter spectrum for some patients.
Although Raj et al. aptly outline current strategies for treatment, two potential mechanisms of disease should not be overlooked since they may attract other practical interventions. Injectables and foreign body implan...Competing Interests: None declared.References
- 1. Satish R. Raj, Artur Fedorowski, Robert S. Sheldon. Diagnosis and management of postural orthostatic tachycardia syndrome. CMAJ 2022;194:E378-E385.
- 2. Cimolai N. Mast cell biology and linkages for non-clonal mast cell activation and autoimmune/inflammatory syndrome induced by adjuvants. SN Compr Clin Med 2020;2:2310-23.
- 3. Cimolai N. Mast cell biology in the context of dysautonomia and neuropathy. Clin Immunol 2020;215:108417.
- 4. Cimolai N. Comparing histamine intolerance and non-clonal mast cell activation syndrome. Intest Res 2020;18(1):134-5.