Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Rev Neurol (Paris). 2022 Apr;178(4):306-314. doi: 10.1016/j.neurol.2021.10.006. Epub 2021 Dec 9.
As part of the non-criteria clinical manifestations, postural orthostatic tachycardia syndrome (POTS), a multisystem autonomic dysfunction, can co-exist with antiphospholipid syndrome (APS). Several pieces of evidence hint on the autoimmune basis of POTS, and its possible association with several autoimmune diseases, including APS. Indeed, the evidence exists in the etiologies, symptomatology, and treatment options. Although infections, viral ones in particular, stress, and pregnancy are etiologies to both POTS and APS, the exact pathophysiological connection is still to be studied taking into consideration the activity of cytokines in both diseases. Nevertheless, certain immunomodulatory treatments used for the catastrophic or obstetrical forms of APS, such as intravenous immunoglobulins (IVIG) and steroids, have been also used for the treatment of POTS resistant to classical treatments. Therefore, our review aims to highlight the association between POTS and APS, shedding light on the common etiologies explaining the pathophysiology of the two disorders, the diagnostic approach to POTS as a possible clinical criterion of APS, and the treatment of APS in the context of treating POTS.
作为非标准临床表现的一部分，体位性心动过速综合征（POTS）是一种多系统自主神经功能障碍，可以与抗磷脂综合征（APS）并存。有几项证据表明 POTS 具有自身免疫基础，并且可能与包括 APS 在内的几种自身免疫性疾病有关。事实上，证据存在于病因、症状和治疗选择中。尽管感染（特别是病毒感染）、压力和妊娠是 POTS 和 APS 的病因，但在考虑两种疾病中细胞因子的活性的情况下，确切的病理生理学联系仍有待研究。然而，某些用于灾难性或产科形式的 APS 的免疫调节治疗，如静脉注射免疫球蛋白（IVIG）和类固醇，也已用于治疗对经典治疗有抗药性的 POTS。因此，我们的综述旨在强调 POTS 和 APS 之间的关联，阐明解释这两种疾病病理生理学的共同病因，以及作为 APS 可能的临床标准的 POTS 的诊断方法，以及在治疗 POTS 的背景下治疗 APS。
