The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.
Autoimmunity in postural orthostatic tachycardia syndrome: Current understanding
Abstract
There is growing interest in the role of autoimmunity in postural orthostatic tachycardia syndrome (POTS). In recent years, investigators have described an increased rate of co-morbid autoimmune disease, and the presence of several neural receptor autoantibodies and non-specific autoimmune markers in POTS. Case reports on the efficacy of immunotherapy in highly selected POTS patients continue to appear in the literature, while no prospective clinical trials have occurred to date. This article summarizes the current state of knowledge on the role of autoimmunity in POTS, the clinical implications of these findings, and prospects for future research.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Antibodies against GPCRs have been linked to a number of conditions, including POTS (Luft, 2013”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Vernino and Stiles, 2018
In the citing paper
“POTS patients (Vernino and Stiles, 2018) and their close relatives (Boris et al., 2020; Shaw et al., 2019) have a higher than expected prevalence of autoimmune disorders including celiac disease (Penny et al., 2016), Hashimoto’s thyroiditis (Blitshteyn, 2015), Sjögren’s syndrome (Goodman et al., 2017), and systemic lupus erythematosus (SLE) (Tang et al., 2004).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as Vernino and Stiles, 2018
In the citing paper
“Serum immunoglobulins isolated from POTS patients have been reported to act as partial agonists to both α- and β-adrenergic receptors in vitro (Fedorowski et al., 2017; Li et al., 2014), a finding independently confirmed by several other groups (Vernino and Stiles, 2018) and expanded to include a wider range of G-protein coupled receptors (GPCRs) as targets (Kharraziha et al., 2020).”
From Postural orthostatic tachycardia syndrome (POTS): State of the science and clinical care from a 2019 National Institutes of Health Expert Consensus Meeting - Part 1 (2021) · cites this paper as Vernino and Stiles, 2018
Citations
Cites
Shiboski, C. H., Shiboski, S. C., Séror, R., Criswell, L. A., Labétoulle, M., Lietman, T. M., Rasmussen, A., Scofield, R. H., Vitali, C., Bowman, S., et al. (2016) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2016-210571 · Cited by 1,420
The vagus nerve and the inflammatory reflex – linking immunity and metabolism
Pavlov, V. A., & Tracey, K. J. (2012) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2012.189 · Cited by 1,040
Koopman, F. A., Chavan, S. S., Miljko, S., Grazio, S., Sokolovic, S., Schuurman, P. R., Mehta, A. D., Levine, Y. A., Faltys, M., Zitnik, R., et al. (2016) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1605635113 · Cited by 1,024
Sheldon, R. S., Grubb, B. P., Olshansky, B., Shen, W.-K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., et al. (2015) · Heart Rhythm · doi:10.1016/j.hrthm.2015.03.029 · Cited by 1,013
Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies
Vernino, S., Low, P. A., Fealey, R. D., Stewart, J. D., Farrugia, G., & Lennon, V. A. (2000) · New England Journal of Medicine · doi:10.1056/nejm200009213431204 · Cited by 674
Sex Differences in Autoimmune Disease from a Pathological Perspective
Fairweather, D., Frisancho-Kiss, S., & Rose, N. R. (2008) · The American Journal of Pathology · doi:10.2353/ajpath.2008.071008 · Cited by 629
The wide spectrum of clinical manifestations in Sjögren's syndrome-associated neuropathy
Mori, K., Iijima, M., Koike, H., Hattori, N., Tanaka, F., Watanabe, H., Katsuno, M., Fujita, A., Aiba, I., Ogata, A., et al. (2005) · Brain · doi:10.1093/brain/awh605 · Cited by 547
Postural orthostatic tachycardia syndrome: the Mayo clinic experience
Thieben, M. J., Sandroni, P., Sletten, D. M., Benrud-Larson, L. M., Fealey, R. D., Vernino, S., Low, P. A., Lennon, V. A., & Shen, W.-K. (2007) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)61027-6 · Cited by 516
Self-citationChronic vagus nerve stimulation in Crohn's disease: a 6‐month follow‐up pilot study
Bonaz, B., Sinniger, V., Hoffmann, D., Clarençon, D., Mathieu, N., Dantzer, C., Vercueil, L., Picq, C., Trocmé, C., Faure, P., et al. (2016) · Neurogastroenterology & Motility · doi:10.1111/nmo.12792 · Cited by 492
Estrogen alters thresholds for B cell apoptosis and activation
Grimaldi, C. M., Cleary, J., Dagtas, A. S., Moussai, D., & Diamond, B. (2002) · Journal of Clinical Investigation · doi:10.1172/jci14873 · Cited by 461
Research works printed but not linked: 7
- Abdallah, 2014, Immunophenotypic profiles in patients with postural orthostatic tachycardia syndrome, Clin. Auton. Res., 24, 215
- Dubey, 2016, M1 and M2 muscarinic receptor antibodies among patients with postural orthostatic tachycardia syndrome: potential disease biomarker, J. Clin. Neuromusc. Dis., 17, 179
- Raj, 2016, The face of postural tachycardia syndrome: a cross-sectional community-based survey, Heart Rhythm., 13, S328
- Rao, 2014, Activating autoantibodies to beta adrenergic and muscarinic receptors associate with atrial tachyarrhythmias in patients with Graves' hyperthyroidism, Endocr. Rev., 35
- Singer, 2014, Autoantibodies in the postural tachycardia syndrome, Clin. Auton. Res., 24, 214
- Tarn, 2017, The effect of non-invasive vagus nerve stimulation on fatigue and immune responses in patients with primary Sjögren's syndrome, Arthritis Rheumatol., 69
- Vlahovic, 2017, Positive GAD-65 antibodies in patients with autonomic dysfunction, Clin. Auton. Res., 27, 339
Cited by
Sorted by citations
Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management
Fedorowski, A. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12852 · Cited by 352
Vernino, S., Bourne, K. M., Stiles, L. E., Grubb, B. P., Fedorowski, A., Stewart, J. M., Arnold, A. C., Pace, L. A., Axelsson, J., Boris, J. R., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102828 · Cited by 304
Self-citationPost-COVID-19 Tachycardia Syndrome: A Distinct Phenotype of Post-Acute COVID-19 Syndrome
Ståhlberg, M., Reistam, U., Fedorowski, A., Villacorta, H., Horiuchi, Y., Bax, J., Pitt, B., Matskeplishvili, S., Lüscher, T. F., Weichert, I., et al. (2021) · The American Journal of Medicine · doi:10.1016/j.amjmed.2021.07.004 · Cited by 183
“It has previously been documented that viral infections can trigger postural orthostatic tachycardia syndrome.(10) The pathophysiological mechanism in postural orthostatic tachycardia syndrome remains elusive but there is evidence of autoimmunity, that is, autoantibodies activating adrenergic and muscarinic receptors;…”
Johansson, M., Ståhlberg, M., Runold, M., Nygren-Bonnier, M., Nilsson, J., Olshansky, B., Bruchfeld, J., & Fedorowski, A. (2021) · JACC: Case Reports · doi:10.1016/j.jaccas.2021.01.009 · Cited by 193
“The syndrome has been postulated to have post-viral autoimmune activation as a possible etiology (3).”
BackgroundThe Interplay between Autonomic Nervous System and Inflammation across Systemic Autoimmune Diseases
Bellocchi, C., Carandina, A., Montinaro, B., Targetti, E., Furlan, L., Rodrigues, G. D., Tobaldini, E., & Montano, N. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23052449 · Cited by 186
“Different studies showed a role of autoantibodies in POTS suggesting an autoimmune mediated pathogenesis of this condition [73,74].”
BackgroundPost-Acute Sequelae of COVID-19 and Cardiovascular Autonomic Dysfunction: What Do We Know?
Bisaccia, G., Ricci, F., Recce, V., Serio, A., Iannetti, G., Chahal, A. A., Ståhlberg, M., Khanji, M. Y., Fedorowski, A., & Gallina, S. (2021) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd8110156 · Cited by 129
“Frequent comorbidities include migraine, irritable bowel syndrome, chronic fatigue syndrome, and autoimmune diseases [73,77].”
BackgroundGunning, W. T., Kvale, H. M., Kramer, P. M., Karabin, B. L., & Grubb, B. P. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.013602 · Cited by 124
“Our specific aim of this project was for proof of concept to evaluate the growing body of evidence that POTS patients have elevated G-coupled protein receptor autoantibodies, and the disorder’s etiology is potentially autoimmune.(46) The significance of autoantibodies against the adrenergic alpha 1 receptor in 89% of…”
BackgroundGonzález-Hermosillo, J. A., Martínez-López, J., Carrillo-Lampón, S. A., Ruiz-Ojeda, D., Herrera-Ramírez, S., Amezcua-Guerra, L. M., & Martínez-Alvarado, M. R. (2021) · Brain Sciences · doi:10.3390/brainsci11060760 · Cited by 116
“as ME/CFS and postural orthostatic tachycardia syndrome are associated with autoantibodies to ß2 adrenoceptors, which could cause ß2 adrenergic receptor dysfunction and the consequent involvement in their pathophysiology [36].”
BackgroundPostural Orthostatic Tachycardia Syndrome (POTS): A critical assessment
Olshansky, B., Cannom, D. S., Fedorowski, A., Stewart, J. M., Gibbons, C. H., Sutton, R., Shen, W.-K., Muldowney, J. A. S., Chung, T., Feigofsky, S., et al. (2020) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2020.03.010 · Cited by 106
The Female-Predominant Persistent Immune Dysregulation of the Post-COVID Syndrome
Ganesh, R., Grach, S. L., Ghosh, A. K., Bierle, D. M., Salonen, B. R., Collins, N. M., Joshi, A. Y., Boeder, N., Anstine, C. V., Mueller, M. R., et al. (2022) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2021.11.033 · Cited by 105
“The presence of a common pathway mediated by immune dysregulation provides a common cause of these conditions, and IL-6 is elevated in these syndromes.(52-56) Interleukin 6 is associated with fatigue and sleep disturbance in chronic stress and inflammation in CS syndromes.”
BackgroundShoenfeld, Y., Ryabkova, V., Scheibenbogen, C., Brinth, L., Martínez-Lavín, M., Ikeda, S., Heidecke, H., Watad, A., Bragazzi, N. L., Chapman, J., et al. (2020) · Clinical Immunology · doi:10.1016/j.clim.2020.108384 · Cited by 74
Mathias, C. J., Owens, A., Iodice, V., & Hakim, A. (2021) · American Journal of Medical Genetics Part C: Seminars in Medical Genetics · doi:10.1002/ajmg.c.31951 · Cited by 65
“There is recent and increasing evidence both on measurement of antibody levels and in response to immunotherapy that autoimmune mechanisms may be causative or contributory (Al-Ansari & Robertson, 2021; Gunning et al., 2019; Vernino & Stiles, 2018; Watari et al., 2018).”
BackgroundAutoimmunity in Long Covid and POTS
El-Rhermoul, F.-Z., Fedorowski, A., Eardley, P., Taraborrelli, P., Panagopoulos, D., Sutton, R., Lim, P., & Dani, M. (2023) · Oxford Open Immunology · doi:10.1093/oxfimm/iqad002 · Cited by 48
“However, autoantibodies against GPCRs are not novel and they are described across a wide state of conditions in diseases ranging from SS to peripartum cardiomyopathy [82].”
BackgroundKharraziha, I., Axelsson, J., Ricci, F., Di Martino, G., Persson, M., Sutton, R., Fedorowski, A., & Hamrefors, V. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.120.015989 · Cited by 54
Liao, Y., & Du, J. (2020) · Neuroscience Bulletin · doi:10.1007/s12264-020-00497-4 · Cited by 46
“On the basis of studies of plasma autoantibodies to adrenergic receptors, the orthostatic tachycardia in patients with POTS is probably attributable to the direct stimulatory effect of cardiac receptor-activating autoimmune antibodies on sinus rhythm control or to a compensatory response to the excessive vasodilation…”
BackgroundStiles, L. E., Cinnamon, J., & Balan, I. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.06.002 · Cited by 37
Self-citationPostural Orthostatic Tachycardia Syndrome (POTS): An Update for Clinical Practice
Sebastian, S. A., Co, E. L., Panthangi, V., Jain, E., Ishak, A., Shah, Y., Vasavada, A. M., & Padda, I. (2022) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2022.101384 · Cited by 41
Adrenergic Autoantibody‐Induced Postural Tachycardia Syndrome in Rabbits
Li, H., Zhang, G.-G., Zhou, L.-P., Nuss, Z., Beel, M., Hines, B., Murphy, T., Liles, J., Zhang, L., Kem, D., et al. (2019) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.119.013006 · Cited by 31
“The potential role of autoimmunity in POTS has gained increased attention in recent years.(8,9) Many patients with POTS report a viral illness or vaccination antedating the onset of their POTS symptoms, suggesting a possible autoimmune cause for POTS in some patients.”
BackgroundAutoimmune Autonomic Disorders
Vernino, S. A. (2020) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000000812 · Cited by 35
Self-citationHall, J., Bourne, K. M., Vernino, S., Hamrefors, V., Kharraziha, I., Nilsson, J., Sheldon, R. S., Fedorowski, A., & Raj, S. R. (2022) · Circulation · doi:10.1161/circulationaha.122.059971 · Cited by 35
Self-citationThe Multisystem Impact of Long COVID: A Comprehensive Review
Negruţ, N., Menegas, G., Kampioti, S., Bourelou, M., Kopanyi, F., Hassan, F. D., Asowed, A., Taleouine, F. Z., Ferician, A. C., & Marian, P. (2024) · Diagnostics · doi:10.3390/diagnostics14030244 · Cited by 41
“Autoimmunity has an important role in the pathophysiology of post-viral POTS, as supported by recent evidence [124].”
BackgroundVernino, S. A., Hopkins, S., Bryarly, M. A., Hernandez, R. S., & Salter, A. R. (2024) · Clinical Autonomic Research · doi:10.1007/s10286-024-01020-9 · Cited by 28
“Other characteristics suggesting an autoimmune cause of POTS include subacute onset following infection, physical injury, immunization or surgery, a personal or family history of autoimmune disease, or laboratory evidence of autoimmunity [4,5].”
InfluentialSelf-citationHow We Treat Autoimmune Small Fiber Polyneuropathy with Immunoglobulin Therapy
Schofield, J. R., & Chémali, K. R. (2018) · European Neurology · doi:10.1159/000498858 · Cited by 27
Dulal, D., Maraey, A. M., Elsharnoby, H. R., Chacko, P., & Grubb, B. P. (2025) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcae111 · Cited by 28
Postural Tachycardia Syndrome in Children and Adolescents: Pathophysiology and Clinical Management
Chen, G., Du, J., Jin, H., & Huang, Y. (2020) · Frontiers in Pediatrics · doi:10.3389/fped.2020.00474 · Cited by 27
Observational case series of postural tachycardia syndrome (PoTS) in post-COVID-19 patients
Gall, N. P., James, S., & Kavi, L. (2022) · British Journal of Cardiology · doi:10.5837/bjc.2022.003 · Cited by 24
The Long-COVID autonomic syndrome in hospitalized patients: A one-year prospective cohort study
Rigo, S., Barbic, F., Khalaf, K., Bisoglio, A., Pani, M., Minonzio, M., Rinaldi, L., Ciccarelli, M., Bordoni, M. G., Verzeletti, P., et al. (2023) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2023.08.018 · Cited by 24
Chandler, R. E. (2019) · BMJ · doi:10.1136/bmj.l2268 · Cited by 23
Knoop, I., Picariello, F., Jenkinson, E., Gall, N., Chisari, C., & Moss-Morris, R. (2023) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.103052 · Cited by 21
Kell, D. B., Khan, A., Kane, B., Lip, G. Y. H., & Pretorius, E. (2024) · Journal of Personalized Medicine · doi:10.3390/jpm14020170 · Cited by 25
Stavılecı, B., Özdemir, E., Özdemir, B., Ereren, E., & Cengız, M. (2022) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2022.02.012 · Cited by 20
“It has been previously documented that viral infections can trigger postural orthostatic tachycardia syndrome [26].”
BackgroundRe: ‘Post-COVID-19 chronic symptoms’ by Davido et al.
Miglis, M. G., Goodman, B. P., Chémali, K. R., & Stiles, L. E. (2020) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2020.08.028 · Cited by 20
“In addition, postviral autonomic impairment may have an autoimmune basis and in some cases is amendable to immunotherapy [4,5].”
Self-citationPost-COVID Syndrome and Tachycardia: Theoretical Base and Treatment Experience
Podzolkov, V. I., Bragina, A. E., Tarzimanova, A. I., Васильева, Л. В., Batrakova, E. P., Lobova, N. V., Bykova, E. E., & Khachuroeva, M. M. (2021) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2021-04-08 · Cited by 24
Eftekhari, H., Maddock, H. L., Pearce, G., Raza, S., Kavi, L., Lim, P. B., Osman, F., & Hayat, S. A. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102808 · Cited by 19
“One broad call has been to improve the understanding of different POTS aetiologies (3), reflected in increasing research into autoimmunity and mast cell activation disorder (34-36).”
BackgroundZhang, Q., Xu, B., & Du, J. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00525 · Cited by 20
Björnson, M., Wijnbladh, K., Törnberg, A., Svensson‐Raskh, A., Svensson, A., Ståhlberg, M., Runold, M., Fedorowski, A., Nygren‐Bonnier, M., & Bruchfeld, J. (2025) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.124.013629 · Cited by 17
Hutt, E., Vajapey, R. S., Iterson, E. H. V., Jaeger, F. J., Cho, L., Ahmed, H. M., & Mayuga, K. A. (2020) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2020.06.013 · Cited by 18
“It is associated with symptoms of lightheadedness, fatigue, blurred vision and exaggerated increase in heart rate while standing, in the absence of orthostatic hypotension [1,2].”
BackgroundGanglionic Acetylcholine Receptor Antibodies in Postural Tachycardia Syndrome
Bryarly, M. A., Raj, S. R., Phillips, L. T., Hynan, L. S., Okamoto, L. E., Arnold, A. C., Paranjape, S. Y., Vernino, M., Black, B. K., & Vernino, S. A. (2021) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000001047 · Cited by 16
“The cause of POTS is likely multifactorial, and autoimmunity is believed to play a role in some patients with subacute onset after infection, physical injury, immunization or surgery, a personal or family history of autoimmune disease, or laboratory evidence of autoimmunity.(4,5)”
BackgroundSelf-citationGunning, W., Kramer, P. M., Cichocki, J. A., Karabin, B., Khuder, S., & Grubb, B. (2022) · Cells · doi:10.3390/cells11050774 · Cited by 14
Ghazal, M., Akkawi, A. R., Fancher, A. J., Oundo, E., Tanzeem, H., Sajjad, L., & Briasoulis, Α. (2024) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2024.102977 · Cited by 17
Wafa, S. E. I., Chahal, C. A. A., Sawatari, H., Khanji, M. Y., Khan, H., Asatryan, B., Ahmed, R., Deshpande, S. A., Providencia, R. A., Deshmukh, A. J., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.024939 · Cited by 14
Deng, J., Li, H., Guo, Y., Zhang, G., Fischer, H., Stavrakis, S., & Yu, X. (2022) · Journal of Interventional Cardiac Electrophysiology · doi:10.1007/s10840-022-01144-w · Cited by 14
“These observations have led investigators to suspect the potential involvement of autoantibodies in the pathogenesis of POTS [5, 6].”
BackgroundCabral-Marques, O., Schimke, L. F., Moll, G., Filgueiras, I. S., Nóbile, A. L., Adri, A. S., do Vale, F. Y. N., Usuda, J. N., Corrêa, Y. L. G., Albuquerque, D., et al. (2025) · Autoimmunity Reviews · doi:10.1016/j.autrev.2025.103855 · Cited by 14
“Moreover, Vernino and Stiles [59] provided a comprehensive overview of the autoimmune landscape in POTS, noting the increased frequency of neural receptor autoantibodies (e.g., ganglionic acetylcholine receptor antibodies) and the co-occurrence of small fiber neuropathy in many patients, which may…”
Postural orthostatic tachycardia syndrome and post-acute COVID-19
Amekran, Y., Damoun, N., & Hangouche, A. J. E. (2022) · Global Cardiology Science and Practice · doi:10.21542/gcsp.2022.13 · Cited by 16
“The most commonly associated symptoms include fatigue, nausea, dizziness, lightheadedness, palpitations, chest pain and exercise intolerance [8, 10, 11].”
BackgroundSpahic, J. M., Ricci, F., Aung, N., Hallengren, E., Axelsson, J., Hamrefors, V., Melander, O., Sutton, R., & Fedorowski, A. (2020) · BMC Cardiovascular Disorders · doi:10.1186/s12872-020-01465-6 · Cited by 13
Afrin, L. B., Dempsey, T. T., & Weinstock, L. B. (2022) · Vaccines · doi:10.3390/vaccines10010127 · Cited by 14
Autoimmunity and postural orthostatic tachycardia syndrome: Implications in diagnosis and management
Aboseif, A., Bireley, J. D., Li, Y., Polston, D. W., & Abbatemarco, J. (2023) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.90a.22093 · Cited by 12
“…conditions such as inappropriate sinus tachycardia, complex regional pain syndrome, and chronic fatigue syndrome, and are thus nonspecifi c. 25 Specifi c antibodies in this class include those directed against alpha-1 adrenergic receptor, beta-1 adrenergic receptor, and beta-2 adrenergic…”
BackgroundChildren With PANS May Manifest POTS
Chan, A. L., Gao, J., Houston, M., Willett, T. A., Farhadian, B., Silverman, M. A., Tran, P., Jaradeh, S. S., Thienemann, M., & Frankovich, J. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.819636 · Cited by 13
Pitarokoili, K., Maier, A., Rubio, E. D. M., Hahn, K., Wallukat, G., Athanasopoulos, D., Grüter, T., Motte, J., Fisse, A. L., & Gold, R. (2021) · Journal of Translational Autoimmunity · doi:10.1016/j.jtauto.2021.100112 · Cited by 11
Postural Orthostatic Tachycardia Syndrome
Zhao, S. Z., & Tran, V. H. (2020) · StatPearls · Cited by 11
Yaxley, K. L. (2020) · SAGE Open Medical Case Reports · doi:10.1177/2050313x20915413 · Cited by 11
Implications of Antimuscarinic Autoantibodies in Postural Tachycardia Syndrome
Li, H., Zhang, G., Forsythe, E., Okamoto, L. E., & Yu, X. (2021) · Journal of Cardiovascular Translational Research · doi:10.1007/s12265-021-10167-z · Cited by 11
Sunami, Y., Sugaya, K., Miyakoshi, N., Iwazaki, O., & Takahashi, K. (2022) · Immunologic research · doi:10.1007/s12026-021-09256-7 · Cited by 9
Human leukocyte antigen associations in postural tachycardia syndrome
Shin, Y., Moon, J., Kim, T., Kim, D., Chang, H., Jun, J., Lee, S., Jung, K., Park, K., Jung, K., et al. (2019) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.766 · Cited by 10
“, female predominance, preceding viral illness, prior vaccination history, and coexistence of other autoimmune conditions) along with autoantibodies.(6) Antibody-mediated autoimmune disorders usually have an HLA class II association.”
BackgroundKitsou, V., Blomberg, B., Lunde, T., & Saeed, S. (2022) · BMJ Case Reports · doi:10.1136/bcr-2022-249608 · Cited by 10
Autoimmune Autonomic Disorders
Golden, E. P., Blackburn, K. M., & Vernino, S. A. (2021) · Springer eBooks · doi:10.1007/978-3-030-61883-4_21 · Cited by 11
Self-citationTufvesson, H., Hamrefors, V., Fedorowski, A., Hansson, M., & Ohlsson, B. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2024.1342351 · Cited by 11
Breaking the silence: Recognizing post-vaccination syndrome
Halma, M. T. J., & Varón, J. (2025) · Heliyon · doi:10.1016/j.heliyon.2025.e43478 · Cited by 9
Zhang, R., Mayuga, K., Shields, R., Cantrell, C., & Wilson, R. G. (2022) · Cureus · doi:10.7759/cureus.31021 · Cited by 10
“High levels of gAChR antibodies have been identified as a defining feature of autoimmune autonomic ganglionopathy (AAG) [27], a rare cause of diffuse autonomic failure.”
BackgroundPozzi, A. T. D., Enechukwu, M., & Blitshteyn, S. (2019) · BMJ Case Reports · doi:10.1136/bcr-2019-229824 · Cited by 9
Guo, Y., Li, H., Deng, J., Zhang, G., Fischer, H., Stavrakis, S., & Yu, X. (2022) · Heart Rhythm O2 · doi:10.1016/j.hroo.2022.12.001 · Cited by 9
“In recent years, autoimmunity has drawn attention as a potential cause of POTS in some patients.(4,5) We and others have identified the presence of antiadrenergic autoantibodies in a subgroup of POTS patients.”
BackgroundLow-Dose Naltrexone Use in Postural Orthostatic Tachycardia Syndrome: A Case Series
Tidd, S. J. S., Cantrell, C., Greene, B. D., & Wilson, R. (2023) · Cureus · doi:10.7759/cureus.43426 · Cited by 6
“This has led to increased calls for clinical trials exploring immunomodulating therapies such as LDN [23-25].”
BackgroundCheng, W., Wang, J., & Lin, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19126974 · Cited by 6
Mannan, H. R., & Pain, C. M. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e12982 · Cited by 6
G protein-coupled receptors related to autoimmunity in postural orthostatic tachycardia syndrome
Sunami, Y., Sugaya, K., & Takahashi, K. (2024) · Immunological Medicine · doi:10.1080/25785826.2024.2370079 · Cited by 6
“Moreover, the identification of several autoantibodies, including anti-G protein-coupled receptor (GPCR) autoantibodies, in the sera of patients with POTS has led some researchers to posit an autoimmune etiology for POTS [3].”
Postural tachycardia syndrome (POTS) and antiphospholipid syndrome (APS): What do we know so far?
Noureldine, H. A., Hasbani, G. E., Eldine, M. N., Nour‐Eldine, W., Taher, A. T., & Uthman, I. W. (2021) · Revue Neurologique · doi:10.1016/j.neurol.2021.10.006 · Cited by 6
Insights into postural orthostatic tachycardia syndrome after COVID-19 in pediatric patients
Cui, Y.-X., Du, J.-B., & Jin, H. (2024) · World Journal of Pediatrics · doi:10.1007/s12519-024-00796-0 · Cited by 6
“Many studies have suggested that the pathogenesis of POTS is related to autoimmunity and thus warrants further studies on IVIG treatment [67].”
Fan, S., Cui, Y., Liao, Y., & Jin, H. (2023) · Children · doi:10.3390/children10071093 · Cited by 7
Pathophysiology and Classification of PoTS
Lloyd, M., & Raj, S. (2020) · Postural Tachycardia Syndrome · doi:10.1007/978-3-030-54165-1_5 · Cited by 4
Postural Tachycardia Syndrome and COVID-19: Focus on Ivabradine Therapy
DIXIT, K., & Frishman, W. H. (2022) · Cardiology in Review · doi:10.1097/crd.0000000000000503 · Cited by 4
“This was the first case reported where POTS had been reversed after a COVID-19 infection.”
BackgroundInfluentialMiglis, M. G., & Muppidi, S. (2020) · Clinical Autonomic Research · doi:10.1007/s10286-019-00661-5 · Cited by 4
Postural Orthostatic Tachycardia Syndrome: Diagnosis and Management Guide for Nurses
Seeley, M., Lau, D. H., & Gallagher, C. (2023) · Nursing Research and Reviews · doi:10.2147/nrr.s394822 · Cited by 3
González-Hermosillo, J. A., Rubio-Vega, A., González-Olvera, K. A. F., Sierra-Beltrán, M., Kostine, A., & Lerma, C. (2021) · Revista de investigaci�n Cl�nica · doi:10.24875/ric.21000199 · Cited by 4
Introduction to Neuroimmunology
Coyle, P. K. (2019) · Current clinical neurology · doi:10.1007/978-3-030-24436-1_1 · Cited by 3
Metabolic targets in the Postural Orthostatic Tachycardia Syndrome: A short thematic review
Glasgow, A. C., & Kim, J. Y. (2024) · Autonomic Neuroscience · doi:10.1016/j.autneu.2024.103232 · Cited by 3
Herrera, A., & Behm, J. (2021) · Occupational Therapy In Health Care · doi:10.1080/07380577.2021.1967548 · Cited by 3
“Other potential mechanisms include autoimmunity (Grubb et al., 2006; Vernino & Stiles, 2018), autonomic and/or small fiber neuropathy (Gibbons et al., 2013; Haensch et al., 2014), hypovolemia, and mast cell activation disorder (Arnold et al., 2018; Bryarly et al., 2019).”
BackgroundHop to It: The First Animal Model of Autoimmune Postural Orthostatic Tachycardia Syndrome
Miller, A. J., & Doherty, T. A. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.014084 · Cited by 3
“case series have shown that immune therapy improves POTS symptoms in patients with comorbid autoimmune diseases and refractory disease.(3,15,16) There is also an ongoing randomized controlled clinical trial to evaluate the efficacy of intravenous immunoglobulin in POTS (ClinicalTrials.”
BackgroundInfluentialConditions Associated with Median Arcuate Ligament Syndrome: POTS, MCAS, EDS
DeCicco, J. P., Johnson, J., & Wilson, R. (2025) · Springer eBooks · doi:10.1007/978-3-031-80740-4_6 · Cited by 2
Kulin, D., Shah, A., Fairlie, T., Staller, K. D., Nurko, S., Keefer, L., Aziz, Q., Drossman, D. A., Jones, M., & Holtmann, G. (2026) · Neurogastroenterology & Motility · doi:10.1111/nmo.70305 · Cited by 2
Hiperhidrose e síndrome de taquicardia pós-COVID-19
Rebêlo, V. C. N., da Silva, E. K. R., Lemos, M. P. R., Cabral, P. U. L., de Carvalho, A. F. M., Feitosa, M. C. P., Coelho, N. P. M. D. F., Monteiro, L. D. M., Portela, F. T. D. C., & Arisawa, E. Â. L. S. (2022) · Research Society and Development · doi:10.33448/rsd-v11i4.27766 · Cited by 2
Complex breathlessness in postural tachycardia syndrome and autonomic dysfunction
Gall, N. P., & Reilly, C. C. (2022) · European Respiratory Society eBooks · doi:10.1183/2312508x.10013621 · Cited by 2
Treatment and Management of Autoimmune Neuropathies
El-Abassi, R. N., Soliman, M. Y., Levy, M. H., & England, J. D. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-71317-7.00015-9 · Cited by 2
Jost, K., Rodriguez, B., Söll, N., Hoepner, R., & Z'Graggen, W. J. (2022) · F1000Research · doi:10.12688/f1000research.109373.1 · Cited by 1
“Shivering Presence N (%) 3 (15) 13 (65)”
Pipedreams, the pandemic and PoTS: is the post-COVID-19 era a turning point for PoTS services?
Opie, M., & Nuttall, M. (2022) · British Journal of Cardiology · doi:10.5837/bjc.2022.007 · Cited by 2
Autoimmune Antibodies in Orthostatic Intolerance Syndromes
Lukáčová, M., Mitro, P., Lazúrová, Z., Hijová, E., Bertková, I., & Valová, K. (2025) · Physiological Research · doi:10.33549/physiolres.935504 · Cited by 1
“Currently, immune-modulatory therapies in POTS are not recommended unless a systemic autoimmune disorder is confirmed [4,22].”
Anaesthetic management of postural orthostatic tachycardia syndrome presenting during pregnancy
Harding, F., Hyndman, N., & Burns, R. (2019) · International Journal of Obstetric Anesthesia · doi:10.1016/j.ijoa.2019.02.001 · Cited by 1
Is PoTS an Autoimmune Condition?
Rull, G., & Lobo, M. (2020) · Springer eBooks · doi:10.1007/978-3-030-54165-1_20 · Cited by 1
Сardiac manifestations of post-COVID syndrome: tachycardia
Bagdasaryan, A. S., Sirunyants, A. A., Pukhnyak, D. V., Kamalyan, Z. A., Remizova, A. I., & Федичева, Н. А. (2023) · EMERGENCY MEDICAL CARE · doi:10.24884/2072-6716-2023-24-1-30-36 · Cited by 1
Varner, C. A. (2020) · Nursing Made Incredibly Easy! · doi:10.1097/01.nme.0000658220.96438.17 · Cited by 1
Broken Connections: The Evidence for Neuroglial Failure in ME/CFSPreprint
Renz‐Polster, H. (2021) · OSF Preprints (OSF Preprints) · doi:10.31219/osf.io/ef3n4 · Cited by 1
Updates in postural tachycardia syndrome
Moon, J. (2021) · Annals of Clinical Neurophysiology · doi:10.14253/acn.2021.23.1.1
“Moreover, patients with POTS have a higher positive rate of antinuclear antibodies than general population,(29) as well as a higher incidence of systemic autoimmune disease, including Hashimoto’s thyroiditis, Sjögren’s syndrome, lupus, and rheumatoid arthritis.(28) Therefore, it has been suggested that POTS should be…”
BackgroundNunura, F., Tulloch-Reid, E., Soliman, A., Weekes, S., Basil, E., Baugh, D. S., & Madu, E. C. (2021) · Acta Scientific Medical Sciences · doi:10.31080/asms.2020.05.0990
VanderPluym, J. H., Chadehumbe, M. A., & Pietris, N. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-83005-8.00023-9
A new light on an old condition
Struhal, W., & Hain, B. (2021) · European Heart Journal - Case Reports · doi:10.1093/ehjcr/ytab499
“Most likely these triggers (i) do not represent a direct cause of POTS and (ii) activate a complex immune system response.(4) A possible interaction between the cardiovascular autonomic nervous system and the immune system is likely of cybernetic nature—one example is an inverse correlation of interleukin-6 serum leve…”
BackgroundPostural orthostatic tachycardia syndrome in children and adolescents
Lee, J. (2022) · Journal of Korean Medical Association · doi:10.5124/jkma.2022.65.2.101
“손발의 저림, 통 증, 관절통, 더위와 추위를 견디지 못하는 증상, 땀의 분비, 가슴 통증, 눈부심 등이 있다[8,15,16].”
Delamont, R. S. (2020) · Springer eBooks · doi:10.1007/978-3-030-54165-1_7
Autoimmune autonomic syndromes
Vernino, S. A., & Low, P. A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-85492-4.00036-3
Self-citation5th Global Conference on Myositis (GCOM)
Werth, V. P., Wilfong, E. M., Mammen, A. L., Oddis, C. V., Saygın, D., Liarski, V. M., Moghadam‐Kia, S., Aggarwal, R., & Ascherman, D. P. (2024) · Clinical and Experimental Rheumatology · doi:10.55563/clinexprheumatol/byxxv1
Long-term clinical outcomes and prognosis
Molinari, L. V., Ricci, F., Gallina, S., Fedorowski, A., & Chahal, C. A. A. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-14001-3.00012-1
Metadata
- Authors
- Vernino, S., & Stiles, L. E.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Stiles, Lauren E.
- Venue
- Autonomic Neuroscience
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 215
- Pages
- 78-82
- ISSN
- 1566-0702 (ISSN-L)
- OpenAlex
- W2801111658
- Cited by
- 107
- References
- 58
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 11 · 2023: 9 · 2022: 24 · 2021: 22 · 2020: 18 · 2019: 8 · 2018: 3
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Autonomic Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Clinical Neurology › Autoimmune Neurological Disorders and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- postural orthostatic tachycardia syndrome, autoimmunity, autoimmune disease comorbidity, autoimmune markers, immunotherapy, autonomic dysfunction
- MeSH terms
- Autoimmune Diseases, Humans, Immunotherapy, Comorbidity, Postural Orthostatic Tachycardia Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
