Erythropoietin in the Treatment of Postural Orthostatic Tachycardia Syndrome
Abstract
Erythropoietin has been reported to improve symptoms of orthostatic intolerance in patients suffering from orthostatic hypotension. Previous reports on the use of erythropoietin in patients with postural orthostatic tachycardia (POTS) have included only a very small number of patients. In the current study, we report on the use of erythropoietin in patients with refractory POTS. The study was approved by the institutional review board. A retrospective nonrandomized analysis was performed on 39 patients evaluated at our autonomic center for POTS from 2003 to 2010. The diagnosis of POTS was based on patient history, physical examination, and response to head-up tilt-table testing. The mean follow-up period was 6 months. The patients were included in the current study if they had a diagnosis of POTS with severe symptoms of orthostatic intolerance and were refractory to the commonly used medications. All these patients were started on erythropoietin, and the response to therapy was considered successful if it provided symptomatic relief. We screened 200 patients with POTS and found 39 patients (age 33 ± 12, 37 females) to be eligible for inclusion in the current study. The response to the treatment was assessed subjectively in each patient and was obtained in a retrospective fashion from patient charts and physician communications. Eight (21%) patients demonstrated no improvement in symptoms after administration of erythropoietin. Three (8%) patients showed an improvement in symptoms of orthostatic intolerance of <3 months. Twenty-seven (71%) patients demonstrated sustained improvement in their symptoms of orthostatic intolerance at the mean follow-up of 6 months. Erythropoietin significantly improved sitting diastolic blood pressure but had no effect on other hemodynamic parameters. In a select group of POTS patients who are refractory to commonly used medications, erythropoietin may help improve symptoms of orthostatic intolerance.
Integrity signals
Registry
Cites
Statistics
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?
Erythropoietin improved symptoms in one study of treatment-refractory POTS patients, at the expense of elevating blood pressure.
“but it did improve symptoms, at the expense of elevating blood pressure, in one study of treatment-refractory POTS patients (72).”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [72]
Erythropoietin does not appear to improve the orthostatic tachycardia of POTS.
“Erythropoietin does not appear to improve the orthostatic tachycardia of POTS (71, 72)”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [72]
Cites
Erythropoietin has a mitogenic and positive chemotactic effect on endothelial cells.
Anagnostou, A. A., Lee, E. S., Kessimian, N., et al. (1990) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.87.15.5978 · Cited by 578 · see citing works
Postural Tachycardia Syndrome: Clinical Features and Follow-up Study
Sandroni, P., Opfer-Gehrking, T. L., McPhee, B. R., & Low, P. A. (1999) · Mayo Clinic Proceedings · doi:10.4065/74.11.1106 · Cited by 194 · see citing works
Streeten, D. H. P., Anderson, G. H., Richardson, R., & THOMAS, F. D. (1988) · PubMed · Cited by 183 · see citing works
Martin, W. J., Smith, J. A., & White, D. G. (1986) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.1986.tb11157.x · Cited by 164 · see citing works
The Postural Tachycardia Syndrome: A Concise Guide to Diagnosis and Management
Grubb, B. P., Kanjwal, Y., & KOSINSKI, D. J. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2005.00318.x · Cited by 154 · see citing works
Self-citationFOUAD, F. M., TADENA-THOME, L., BRAVO, E. L., & TARAZI, R. C. (1986) · Annals of Internal Medicine · doi:10.7326/0003-4819-104-3-298 · Cited by 154 · see citing works
Carlini, R. G., Obialo, C. I., & Rothstein, M. (1993) · American Journal of Hypertension · doi:10.1093/ajh/6.2.103 · Cited by 123 · see citing works
Rosen, S. G., & Cryer, P. E. (1982) · The American Journal of Medicine · doi:10.1016/0002-9343(82)90559-9 · Cited by 104 · see citing works
The Postural Orthostatic Tachycardia Syndrome:
Kanjwal, Y., KOSINSKI, D. J., & Grubb, B. P. (2003) · Pacing and Clinical Electrophysiology · doi:10.1046/j.1460-9592.2003.t01-1-00262.x · Cited by 103 · see citing works
Self-citationPerera, R., Isola, L. M., & Kaufmann, H. (1995) · Clinical Autonomic Research · doi:10.1007/bf01824009 · Cited by 99 · see citing works
Erythropoietin increases cytosolic free calcium concentration in vascular smooth muscle cells
Neusser, M., Tepel, M., & Zidek, W. (1993) · Cardiovascular Research · doi:10.1093/cvr/27.7.1233 · Cited by 54 · see citing works
Takahashi, K., Totsune, K., Imai, Y., et al. (1993) · Clinical Science · doi:10.1042/cs0840047 · Cited by 54 · see citing works
Grubb, B. P., Kanjwal, M. Y., & KOSINSKI, D. J. (2001) · Journal of Interventional Cardiac Electrophysiology · doi:10.1023/a:1009845521949 · Cited by 51 · see citing works
Self-citationThe pathogenesis of hyperadrenergic postural hypotension in diabetic patients
Tohmeh, J. F., SHAH, S. D., & Cryer, P. E. (1979) · The American Journal of Medicine · doi:10.1016/0002-9343(79)90733-2 · Cited by 46 · see citing works
Treatment of orthostatic tachycardia with erythropoietin
Hoeldtke, R. D., Horvath, G. G., & Bryner, K. D. (1995) · The American Journal of Medicine · doi:10.1016/s0002-9343(99)80230-7 · Cited by 38 · see citing works
Syncope Resulting from Autonomic Insufficiency Syndromes Associated with Orthostatic Intolerance
Grubb, B. P., & KOSINSKI, D. J. (2001) · Medical Clinics of North America · doi:10.1016/s0025-7125(05)70322-9 · Cited by 25 · see citing works
Self-citationCryer, P. E. (1980) · Metabolism · doi:10.1016/0026-0495(80)90028-1 · Cited by 24 · see citing works
Normal and abnormal sympathoadrenal function; in patients with insulin-dependent diabetes mellitus.
Pe, C. (1982) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Postural tachycardia syndrome—current experience and concepts
Mathias, C. J., Low, D. A., Iodice, V., Owens, A. P., Kirbis, M., & Grahame, R. (2012) · Nature Reviews Neurology · doi:10.1038/nrneurol.2011.187 · Cited by 251 · see citing works
Pediatric Disorders of Orthostatic Intolerance
Stewart, J. M., Boris, J. R., Chelimsky, G., Fischer, P. R., Fortunato, J. E., Grubb, B. P., Heyer, G. L., Jarjour, I. T., Medow, M. S., Numan, M. T., et al. (2018) · Pediatrics · doi:10.1542/peds.2017-1673 · Cited by 222 · see citing works
Self-citationPostural orthostatic tachycardia syndrome: mechanisms and new therapies
Mar, P. L., & Raj, S. R. (2020) · Annual Review of Medicine · doi:10.1146/annurev-med-041818-011630 · Cited by 122 · see citing works
Pharmacotherapy for postural tachycardia syndrome
Miller, A. J., & Raj, S. R. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.04.008 · Cited by 91 · see citing works
Efficacy of Therapies for Postural Tachycardia Syndrome: A Systematic Review and Meta-analysis
Wells, R., Elliott, A. D., Mahajan, R., Page, A., Iodice, V., Sanders, P., & Lau, D. H. (2018) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2018.01.025 · Cited by 67 · see citing works
- Authors
- Kanjwal, K., Saeed, B., Karabin, B., Kanjwal, Y., Sheikh, M., & Grubb, B. P.
- Affiliations
- University of Toledo Medical Center (US)
- Corresponding author
- Grubb, Blair P.
- Venue
- American Journal of Therapeutics
- Published
- 2012-03
- Volume
- 19
- Issue
- 2
- Pages
- 92-95
- ISSN
- 1075-2765 (ISSN-L)
- OpenAlex
- W1970240102
- Cited by
- 34
- References
- 18
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2020: 2 · 2019: 2 · 2018: 5 · 2017: 3 · 2016: 1 · 2014: 4 · 2013: 3 · 2012: 1
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
- Keywords
- erythropoietin, postural orthostatic tachycardia syndrome, orthostatic intolerance, diastolic blood pressure, autonomic dysfunction, symptom relief
- MeSH terms
- Adult, Blood Pressure, Erythropoietin, Female, Heart Rate, Hematinics, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Tilt-Table Test, 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
