| Hyperadrenergic postural tachycardia syndrome in mast cell activation disorders. | |
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MedLine Citation:
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PMID: 15710782 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Postural tachycardia syndrome (POTS) is a disabling condition that commonly affects otherwise normal young females. Because these patients can present with a flushing disorder, we hypothesized that mast cell activation (MCA) can contribute to its pathogenesis. Here we describe POTS patients with MCA (MCA+POTS), diagnosed by episodes of flushing and abnormal increases in urine methylhistamine, and compared them to POTS patients with episodic flushing but normal urine methylhistamine and to normal healthy age-matched female controls. MCA+POTS patients were characterized by episodes of flushing, shortness of breath, headache, lightheadedness, excessive diuresis, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting. Triggering events include long-term standing, exercise, premenstrual cycle, meals, and sexual intercourse. In addition, patients were disabled by orthostatic intolerance and a characteristic hyperadrenergic response to posture, with orthostatic tachycardia (from 79+/-4 to 114+/-6 bpm), increased systolic blood pressure on standing (from 117+/-5 to 126+/-7 mm Hg versus no change in POTS controls), increased systolic blood pressure at the end of phase II of the Valsalva maneuver (157+/-12 versus 117+/-9 in normal controls and 119+/-7 mm Hg in POTS; P=0.048), and an exaggerated phase IV blood pressure overshoot (50+/-10 versus 17+/-3 mm Hg in normal controls; P<0.05). In conclusion, MCA should be considered in patients with POTS presenting with flushing. These patients often present with a typical hyperadrenergic response, but beta-blockers should be used with great caution, if at all, and treatment directed against mast cell mediators may be required. |
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Authors:
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Cyndya Shibao; Carmen Arzubiaga; L Jackson Roberts; Satish Raj; Bonnie Black; Paul Harris; Italo Biaggioni |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. Date: 2005-02-14 |
Journal Detail:
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Title: Hypertension Volume: 45 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-25 Completed Date: 2005-10-25 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: United States |
Other Details:
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Languages: eng Pagination: 385-90 Citation Subset: IM |
Affiliation:
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Division of Clinical Pharmacology, Department of Medicine and Pharmacology, and the Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, Tenn 37212, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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adverse effects,
therapeutic use Adult Autonomic Nervous System / physiopathology* Case-Control Studies Female Histamine H1 Antagonists / therapeutic use Histamine H2 Antagonists / therapeutic use Humans Hypotension, Orthostatic / drug therapy, physiopathology* Mast Cells* Methyldopa / therapeutic use Sympatholytics / therapeutic use Syndrome Tachycardia / drug therapy, physiopathology* |
| Grant Support | |
ID/Acronym/Agency:
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HL56693/HL/NHLBI NIH HHS; HL67232/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Histamine H1 Antagonists; 0/Histamine H2 Antagonists; 0/Sympatholytics; 555-30-6/Methyldopa |
| Comments/Corrections | |
Comment In:
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Hypertension. 2005 Mar;45(3):354-5
[PMID:
15710781
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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