Human papillomavirus vaccination may be temporally associated with the development of new onset POTS in young women, highlighting the need for clinical awareness and prompt management.
May indicate rare temporal POTS link after HPV vaccination in young women; hypothesis-generating and should not change practice.
BACKGROUND AND PURPOSE: Postural tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that may have an autoimmune etiology. METHODS: Six patients who developed new onset POTS 6 days to 2 months following human papillomavirus vaccination are reported. RESULTS: Three patients also had neurocardiogenic syncope, and three patients were diagnosed with possible small fiber neuropathy. Symptoms in all patients improved over 3 years with pharmacotherapy and non-pharmacological measures but residual symptoms persisted. Molecular mimicry with formation of cross-reacting autoantibodies to the potential targets of the autonomic ganglia, neurons, cardiac proteins or vascular receptors is considered as a possible pathogenesis of new onset POTS after immunization. CONCLUSION: Correct diagnosis of POTS and awareness that POTS may occur after vaccination in young women is essential for prompt and effective management of this condition.
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Svetlana Blitshteyn (2013) studied this question.
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