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Cleveland Clinic Journal of MedicineAutoimmunity and Postural Orthostatic Tachycardia Syndrome: Implications in Diagnosis and Management

Despite the fact that the etiology and pathophysiologic mechanisms causing POTS are unknown, a clinical diagnosis can be obtained with a focused history, examination, and basic diagnostic evaluation.

Postural orthostatic tachycardia syndrome (POTS) is a complex and often misunderstood condition that affects 0.2% to 1% of people in developed countries. This article explores the potential connections between POTS and autoimmune disorders, shedding light on the diagnostic challenges and therapeutic considerations for healthcare professionals.

Key Points:

  • POTS is defined by sustained tachycardia upon standing without orthostatic hypotension.
  • Similarities between POTS and autoimmune disorders suggest an immune mechanism in some patients.
  • Diagnosis can be made clinically without extensive testing, but atypical features may require further evaluation.
  • Immunotherapies are not currently recommended for POTS, but clinical trials are underway.

Additional Points:

  • Typical onset age is between 15 and 45, with at least 80% of patients being women.
  • Symptoms can be both cardiovascular and noncardiovascular, often following triggers like infection, surgery, or trauma.
  • Various mechanisms may be involved in POTS, including increased sympathetic nervous system activity and immune dysregulation.


  • Understanding the potential autoimmune connections in POTS may lead to more targeted diagnostic approaches and treatment strategies, but further research is needed to clarify these complex relationships.

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Did You Know?
From 16% to 20% of patients with POTS have a coexisting autoimmune disease, and many have a family history of one.

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