Department of Pediatrics, Universidad del Valle, Cali, Colombia.
Miller School of Medicine, University of Miami, Miami, Florida, USA.
Andes Pediatr. 2022 Feb;93(1):53-58. doi: 10.32641/andespediatr.v93i1.3755. Epub 2022 Mar 29.
Children with joint hypermobility, postural orthostatic tachycardia syndrome, and orthostatic hypotension report autonomic symptoms such as dizziness, nausea, headaches, and palpitations. It is unclear if there is a pathophysiological link between connective tissue disorders and autonomic symptoms. There is no published data on the prevalence of disorder at the community level.
To assess the prevalence of joint hypermobility, orthostatic hypotension, and postural or thostatic tachycardia syndrome in children.
To determine the relationship bet ween joint hypermobility, orthostatic hypotension, and postural orthostatic tachycardia syndrome.
Participants aged 10 to 18 years were selected from public schools in three Colombian cities. The surveys included historical questions on the incidence of dizziness, nausea, headache, tremor, blurred vision, vertigo, anxiety, near syncope and syncope, sweating, palpitations triggered by standing in the two months prior to the investigation. Each of these signs and symptoms was also assessed during the recumbency (10 minutes) and standing (2, 5 and 10 minutes) phases of the investigation. HR and BP measurements were obtained at the same intervals. Joint mobility was measured with a mechanical goniometer and assessed with the Beighton score.
Prevalence of joint hyperlaxity: 87 of 306 (28.4%). Prevalence of orthostatic hypotension: 5 of 306 (1.6%). Prevalen ce of postural orthostatic tachycardia syndrome: 6 of 306 (2.0%). Of 87 children with joint hyperlaxi ty, only 1 child had joint hyperlaxity at the same time as postural hypotension (1.2%) (p = 0.6735), and 1 child had joint hyperlaxity and postural orthostatic tachycardia syndrome simultaneously (1.2%) (p = 0.5188).
Children with joint hyperlaxity did not have a higher prevalence of postural orthostatic tachycardia syndrome and orthostatic hypotension. It seems unlikely that con nective tissue disorders are responsible for most cases of postural orthostatic tachycardia syndrome and orthostatic hypotension in the community. Of note, the pathophysiology of postural orthostatic tachycardia syndrome and orthostatic hypotension requires further investigation.
患有关节过度活动症、体位性心动过速综合征和直立性低血压的儿童会报告自主神经症状，如头晕、恶心、头痛和心悸。目前尚不清楚结缔组织疾病和自主神经症状之间是否存在病理生理学联系。在社区层面，尚无关于疾病患病率的已发表数据。
评估儿童关节过度活动症、直立性低血压和体位性心动过速综合征的患病率。
确定关节过度活动症、直立性低血压和体位性心动过速综合征之间的关系。
从哥伦比亚三个城市的公立学校中选择 10 至 18 岁的参与者。问卷调查包括在调查前两个月内头晕、恶心、头痛、震颤、视力模糊、眩晕、焦虑、接近晕厥和晕厥、出汗、心悸等症状的发生率。在调查的卧位（10 分钟）和站立位（2、5 和 10 分钟）期间，还评估了这些体征和症状。在相同的时间间隔内测量 HR 和 BP。使用机械量角器测量关节活动度，并使用 Beighton 评分进行评估。
关节过度松弛的患病率：306 名儿童中有 87 名（28.4%）。直立性低血压的患病率：306 名儿童中有 5 名（1.6%）。体位性心动过速综合征的患病率：306 名儿童中有 6 名（2.0%）。87 名关节过度松弛的儿童中，只有 1 名儿童同时患有关节过度松弛和直立性低血压（1.2%）（p=0.6735），1 名儿童同时患有关节过度松弛和体位性心动过速综合征（1.2%）（p=0.5188）。
患有关节过度松弛的儿童并没有更高的体位性心动过速综合征和直立性低血压患病率。结缔组织疾病似乎不是社区中大多数体位性心动过速综合征和直立性低血压病例的原因。值得注意的是，体位性心动过速综合征和直立性低血压的病理生理学需要进一步研究。
