The DOI matches its Crossref record; 174 of the 174 references it cites were found in a registry or an index.
Pediatric Disorders of Orthostatic Intolerance
Open accessAbstract
Orthostatic intolerance (OI), having difficulty tolerating an upright posture because of symptoms or signs that abate when returned to supine, is common in pediatrics. For example, ∼40% of people faint during their lives, half of whom faint during adolescence, and the peak age for first faint is 15 years. Because of this, we describe the most common forms of OI in pediatrics and distinguish between chronic and acute OI. These common forms of OI include initial orthostatic hypotension (which is a frequently seen benign condition in youngsters), true orthostatic hypotension (both neurogenic and nonneurogenic), vasovagal syncope, and postural tachycardia syndrome. We also describe the influences of chronic bed rest and rapid weight loss as aggravating factors and causes of OI. Presenting signs and symptoms are discussed as well as patient evaluation and testing modalities. Putative causes of OI, such as gravitational and exercise deconditioning, immune-mediated disease, mast cell activation, and central hypovolemia, are described as well as frequent comorbidities, such as joint hypermobility, anxiety, and gastrointestinal issues. The medical management of OI is considered, which includes both nonpharmacologic and pharmacologic approaches. Finally, we discuss the prognosis and long-term implications of OI and indicate future directions for research and patient management.
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
“These symptoms are not directly related to the observed haemodynamic disorders [3,5,7,20,35].”
From Postural orthostatic tachycardia syndrome: clinical presentation, aetiology and management (2019) · cites this paper as [20]
Citations
Cites
Boulton, A. J. M., Vinik, A. I., Arezzo, J. C., Bril, V., Feldman, E. L., Freeman, R., Malik, R. A., Maser, R. E., Sosenko, J. M., & Ziegler, D. (2005) · Diabetes Care · doi:10.2337/diacare.28.4.956 · Cited by 1,859
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0119-5 · Cited by 1,697 · cited 1×
“2018;141(1):e20171673 disclaimer: The guidelines/recommendations in”
Self-citationFreeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Autonomic Neuroscience · doi:10.1016/j.autneu.2011.02.004 · Cited by 1,243
Self-citationDietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate
Institute of Medicine (2005) · National Academies Press eBooks · doi:10.17226/10925 · Cited by 1,054
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
Self-citationHEAD-UP TILT: A USEFUL TEST FOR INVESTIGATING UNEXPLAINED SYNCOPE
Kenny, R. A., Bayliss, J. M., Ingram, A., & Sutton, R. (1986) · The Lancet · doi:10.1016/s0140-6736(86)91665-x · Cited by 777
Rossi, P., Andriesse, G. I., Oey, P. L., Wieneke, G. H., Roelofs, J. M. M., & Akkermans, L. M. A. (1998) · Journal of the Neurological Sciences · doi:10.1016/s0022-510x(98)00276-7 · Cited by 767
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
Katirji, M. B. (1993) · Neurology · doi:10.1212/wnl.43.11.2429 · Cited by 590
Idiopathic postural orthostatic tachycardia syndrome: An attenuated form of acute pandysautonomia?
Schondorf, R., & Low, P. A. (1993) · Neurology · doi:10.1212/wnl.43.1_part_1.132 · Cited by 548
Research works printed but not linked: 3
- European Society of Cardiology, 2009, The European Society of Cardiology Guidelines for the diagnosis and management of syncope reviewed by Angel Moya, MD, FESC, Chair of the Guideline Taskforce with J. Taylor, MPhil., Eur Heart J, 30, 2539
- Gibbons, 2014, Model Coverage Testing Autonomic Testing
- Low, 1997, Postural tachycardia syndrome, 681
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
Shaw, B. H., Stiles, L. E., Bourne, K., Green, E. A., Shibao, C. A., Okamoto, L. E., Garland, E. M., Gamboa, A., Diedrich, A., Raj, V., et al. (2019) · Journal of Internal Medicine · doi:10.1111/joim.12895 · Cited by 326
Identification and Management of Eating Disorders in Children and Adolescents
Hornberger, L. L., Lane, M. A., Hornberger, L. L., Lane, M. A., Breuner, C. C., Alderman, E. M., Grubb, L. K., Powers, M. E., Upadhya, K. K., Wallace, S. B., et al. (2020) · PEDIATRICS · doi:10.1542/peds.2020-040279 · Cited by 330
Wang, C., Li, Y., Liao, Y., Tian, H., Huang, M., Dong, X., Shi, L., Sun, J., Jin, H., Du, J., et al. (2018) · 中国科学通报：英文版 · doi:10.1016/j.scib.2018.09.019 · Cited by 123
van de Berg, R., Widdershoven, J. C. C., Bisdorff, A., Evers, S., Vacher, S. R. W., Cushing, S. L., Mack, K. J., Kim, J. S., Jahn, K., Strupp, M. L., et al. (2020) · Journal of Vestibular Research · doi:10.3233/ves-200003 · Cited by 125
Metadata
- Authors
- 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., Pianosi, P. T., Singer, W., Tarbell, S., Chelimsky, T. C., & The Pediatric Writing Group of the American Autonomic Society
- Affiliations
- New York Medical College (US)
- Children's Hospital of Philadelphia (US)
- Medical College of Wisconsin (US)
- Mayo Clinic (US)
- Lurie Children's Hospital (US)
- University of Toledo Medical Center (US)
- Nationwide Children's Hospital (US)
- Texas Children's Hospital (US)
- University of Texas Houston, Houston, Texas; and
- Children's Hospital Colorado (US)
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2018-01-01
- Volume
- 141
- Issue
- 1
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC5744271
- OpenAlex
- W2771422290
- Cited by
- 222
- References
- 174
- Citations by year
- 2026: 26 · 2025: 27 · 2024: 23 · 2023: 24 · 2022: 38 · 2021: 25 · 2020: 33 · 2019: 12 · 2018: 13
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- PEDIATRICS (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Touro Scholar (Touro College) (submittedVersion)
- Funders
- U.S. Food and Drug Administration (R01 FD004789)
- Agency for Healthcare Research and Quality (HHSA 290 2015 00013I)
- National Heart, Lung, and Blood Institute (R01HL112736, R01HL134674, R01HL074873)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK083538)
- National Institute of Neurological Disorders and Stroke (R21NS094644, K23NS075141, R01NS092625)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- orthostatic intolerance, orthostatic hypotension, vasovagal syncope, postural orthostatic tachycardia syndrome, neurogenic orthostatic hypotension, syncope, rapid weight loss, mast cell activation, central hypovolemia, joint hypermobility, anxiety, gastrointestinal symptoms, pediatric patients, diagnosis, treatment, prognosis
- MeSH terms
- Adolescent, Age Factors, Child, Postural Balance, Female, Humans, Hypotension, Orthostatic, Male, Pediatrics, Prognosis, Incidence, Risk Assessment, Tilt-Table Test, Syncope, Vasovagal, Orthostatic Intolerance, 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
