Postural orthostatic tachycardia syndrome following Lyme disease
By Linda on Feb 21, 2011 in Infections
Excerpt:
Background: A subgroup of patients suffering from Lyme disease (LD) may
initially respond to antibiotics only to later develop a syndrome of fatigue,
joint pain and cognitive dysfunction referred to as ‘post treatment LD
syndrome’. We report on a series of patients who developed autonomic dysfunction
in the form of postural orthostatic tachycardia syndrome (POTS). Methods: All of
the patients in this report had suffered from LD in the past and were
successfully treated with antibiotics. All patients were apparently well, until
years later when they presented with fatigue, cognitive dysfunction and
orthostatic intolerance. These patients were diagnosed with POTS on the basis of
clinical features and results of the tilt table (HUTT) testing. Results: Five
patients (all women), aged 22-44 years, were identified for inclusion in this
study. These patients developed symptoms of fatigue, cognitive dysfunction,
orthostatic palpitations and either near syncope or frank syncope. The
debilitating nature of these symptoms had resulted in lost of the employment or
inability to attend school. Three patients were also suffering from migraine,
two from anxiety and depression and one from hypertension. All patients
demonstrated a good response to the employed treatment. Four of the five were
able to engage in their activities of daily living and either resumed employment
or returned to school. Conclusions: In an appropriate clinical setting,
evaluation for POTS in patients suffering from post LD syndrome may lead to
early recognition and treatment, with subsequent improvement in symptoms of
orthostatic intolerance. (Cardiol J 2011; 18, 1: 63-66).
