Successful treatment of postural orthostatic tachycardia and mast cell activation syndromes using naltrexone, immunoglobulin and antibiotic treatment

Weinstock, Leonard B.; Brook, Jill B; Myers, Trisha L; Goodman, Brent P.

doi:10.1136/bcr-2017-221405

Cited by 28 publications

(27 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Generally, those favoring the consensus-2 criteria have observed non-trivial overlaps among the populations with these diseases (e.g. [31][32][33][34][35]), hinting at commonalities in these diseases' mechanistic roots, and those favoring the consensus-1 criteria have published contrary assertions (e.g. [23,24,36]).…”

Section: Molderings Et Al Proposal For Diagnostic Criteria For Mcasmentioning

confidence: 99%

Diagnosis of mast cell activation syndrome: a global “consensus-2”

Ackerley²,

et al. 2020

View full text Add to dashboard Cite

The concept that disease rooted principally in chronic aberrant constitutive and reactive activation of mast cells (MCs), without the gross MC neoplasia in mastocytosis, first emerged in the 1980s, but only in the last decade has recognition of “mast cell activation syndrome” (MCAS) grown significantly. Two principal proposals for diagnostic criteria have emerged. One, originally published in 2012, is labeled by its authors as a “consensus” (re-termed here as “consensus-1”). Another sizable contingent of investigators and practitioners favor a different approach (originally published in 2011, newly termed here as “consensus-2”), resembling “consensus-1” in some respects but differing in others, leading to substantial differences between these proposals in the numbers of patients qualifying for diagnosis (and thus treatment). Overdiagnosis by “consensus-2” criteria has potential to be problematic, but underdiagnosis by “consensus-1” criteria seems the far larger problem given (1) increasing appreciation that MCAS is prevalent (up to 17% of the general population), and (2) most MCAS patients, regardless of illness duration prior to diagnosis, can eventually identify treatment yielding sustained improvement. We analyze these proposals (and others) and suggest that, until careful research provides more definitive answers, diagnosis by either proposal is valid, reasonable, and helpful.

show abstract

Section: Molderings Et Al Proposal For Diagnostic Criteria For Mcasmentioning

confidence: 99%

Diagnosis of mast cell activation syndrome: a global “consensus-2”

Ackerley²,

et al. 2020

View full text Add to dashboard Cite

show abstract

“…These studies support an autoimmune basis in a substantial number of POTS patients, opening up a window for potential immunotherapy in refractory POTS patients. Weinstock et al report the successful treatment of POTS associated with mast cell activation syndrome with intravenous immunoglobulin [18].…”

Section: Discussionmentioning

confidence: 99%

Postural Orthostatic Tachycardia Syndrome Misdiagnosed as Anxiety: A Case Report with a Review of Therapy and Pathophysiology

Kesserwani

2020

Cureus

View full text Add to dashboard Cite

Dizziness can be protean with multiple phenotypes. One common phenotype in the young population is postural orthostatic tachycardia syndrome (POTS). POTS has a unique cardiovascular signature with a fascinating range of etiologies and pharmacodynamic substrates. This condition can pass undiagnosed for many years and is often mistaken as an anxiety disorder due to some of its hyperadrenergic manifestations. We present one such case and then flesh out the treatment strategies, both conservative and pharmacologic. We finally describe the various underlying pathophysiologic mechanisms of POTS and its sub-types and outline the various aberrant cardiovascular reflexes. We also describe the power spectra of the heart rate variability frequency bands and their underlying physiologic basis.

show abstract

“…3 Regular intravenous saline infusions, sinus node modification, and drugs blocking norepinephrine reuptake transporters are not recommended in POTS patients. 3 Intravenous immunoglobulin is being explored 19 for select patients with an immune form of POTS.…”

Section: Discussionmentioning

confidence: 99%

Acute Water Ingestion as a Treatment for Postural Orthostatic Tachycardia Syndrome

Ziffra

Olshansky

2019

J Innov Cardiac Rhythm Manage.

View full text Add to dashboard Cite

A 24-year-old female presented to our clinic with symptomatic tachycardia. In the clinic, she was able to replicate her symptoms, which were due to tachycardia in a standing position that resolved upon sitting. The patient was then offered eight ounces (236.6 mL) of water and, after consumption of such, the standing tachycardia was no longer observed. A diagnosis of postural orthostatic tachycardia syndrome (POTS) was made. This case report discusses a novel approach to acute treatment for POTS.

show abstract

Successful treatment of postural orthostatic tachycardia and mast cell activation syndromes using naltrexone, immunoglobulin and antibiotic treatment

Cited by 28 publications

References 26 publications

Diagnosis of mast cell activation syndrome: a global “consensus-2”

Diagnosis of mast cell activation syndrome: a global “consensus-2”

Postural Orthostatic Tachycardia Syndrome Misdiagnosed as Anxiety: A Case Report with a Review of Therapy and Pathophysiology

Acute Water Ingestion as a Treatment for Postural Orthostatic Tachycardia Syndrome

Contact Info

Product

Resources

About