Key result
New insights into autonomic dysfunction and the inflammatory reflex guide management of diverse patient symptoms.
Why the study?
Patients with autonomic dysfunction present with diverse symptoms that may be misdiagnosed due to failure to recognize a common underlying mechanism.
This review provides an updated clinical approach to understanding and managing autonomic dysfunction, including postural tachycardia syndrome.
Answers are grounded in this paper and cite their sources.
Supports updated approaches to autonomic dysfunction; leaves open prospective validation before changing practice.
Patients with autonomic dysfunction may present with a variety of seemingly unrelated symptoms, both generalised and involving specific systems, including fatigue, difficulty concentrating, orthostatic intolerance, palpitations, constipation or diarrhoea, early satiety, urinary retention or incontinence and erectile dysfunction. Failure to connect the diverse symptoms with a single underlying mechanism may lead to incorrect diagnoses, inappropriate interventions and frustration on the part of both doctors and patients. We describe recent developments in the understanding of the pathophysiology of autonomic dysfunction, including the link between the autonomic and immune systems resulting in the 'inflammatory reflex'. We then provide a rationale to guide the management of patients exhibiting features of autonomic dysfunction, including postural tachycardia syndrome.
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Wells et al. (2016) conducted a review in Autonomic dysfunction. Recent developments in understanding the pathophysiology of autonomic dysfunction, including the inflammatory reflex, provide a rationale to guide the management of patients with these diverse symptoms.
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