Clinical phenotype of postural orthostatic tachycardia associated with anti-adrenergic receptor antibodies

  1. Fernández-Valle, Tamara 1
  2. Maria Ángeles Acera Gil 2
  3. Tijero, Beatriz 2
  4. Pérez-Concha, Tomás 3
  5. Del Pino, Rocío 4
  6. Murueta-Goyena, Ane 4
  7. Vicente-Lafuente, José 5
  8. Boyero, Sabas 6
  9. Ruiz-López, Marta 3
  10. Martínez-Alday, Jesús-Daniel 7
  11. Ugarte, Amaia 8
  12. Ruiz-Irastorza, Guillermo 8
  13. Ribacoba, Laureano 8
  14. López-de-Munain, Adolfo 9
  15. Gabilondo, Iñigo 10
  16. Gómez-Esteban, Juan-Carlos 1
  1. 1 (a) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Biocruces Bizkaia Health Research Institute. Neurodegenerative Diseases Group. Barakaldo, Spain. (b) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Neurology Department, Barakaldo, Spain. (c) University of the Basque Country (UPV/EHU). Department of Neuroscience. Leioa, Spain.
  2. 2 (d) San Juan de Dios Hospital. Autonomic Center (NeuroTek). Santurtzi, Spain.
  3. 3 (a) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Biocruces Bizkaia Health Research Institute. Neurodegenerative Diseases Group. Barakaldo, Spain. (b) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Neurology Department, Barakaldo, Spain.
  4. 4 (a) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Biocruces Bizkaia Health Research Institute. Neurodegenerative Diseases Group. Barakaldo, Spain.
  5. 5 (c) University of the Basque Country (UPV/EHU). Department of Neuroscience. Leioa, Spain.
  6. 6 (b) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Neurology Department, Barakaldo, Spain.
  7. 7 (f) Basque Health Service-Osakidetza. Bilbao-Basurto Integrated Health Organization. Cardiology Service. Arrhythmia Unit. Bilbao, Spain.
  8. 8 (g) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Biocruces Bizkaia Health Research Institute. Internal Medicine Department. Autoimmune Diseases Research Unit. Barakaldo, Spain.
  9. 9 (h) Basque Health Service-Osakidetza. Donostialdea Integrated Health Organization. Donostia University Hospital. Biodonostia Health Research Institute. Neurosciences Area. San Sebastian, Spain. (i) Department of Neurology. University Donostia Hospital, San Sebastian, Spain.
  10. 10 (e) Ikerbasque: The Basque Foundation for Science. Bilbao, Spain.
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Revue:
Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

ISSN: 0304-4858,  2173-2302

Année de publication: 2023

Volumen: 120

Número: 2

Pages: 66-73

Type: Article

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D'autres publications dans: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios

Résumé

Helburua: Gure helburua takikardia postural ortostatiko autoinmune (POTS) sindromearen ezaugarri klinikoak eta hemodinamikoak deskribatzea da; entitate horren maiztasuna eta ezaugarri klinikoak oraindik ez daude behar bezala zehaztuta.Metodoak: Biomarkatzaile klinikoen, hemodinamikoen eta autoinmunitate serikoko biomarkatzaileen atzera begirako analisia POTak eta 79 kontrol parekatu dituzten 105 pazienterengan, adinaren eta sexuaren arabera. Adierazpen klinikoak eta komorbilitate garrantzitsuak erregistratzen dira. Parte-hartzaileek proba autonomiko kardiobaskular kuantitatibo ez-inbaditzaileak egin zituzten, honako hauek neurtuz: bihotz-maiztasunaren aldaketak (FC) eta presio arteriala (PA), sentikortasun barorrefleja (BRS), erresistentzia periferiko totala (TPR), bolumen sistolikoa (BS) eta bihotz-indizea arnasketa sakonari erantzuteko, baltsa-maniobra, 60º-ko mahai baskulatzailea eta larruazalaren eroankortasun elektrokimikoaren ebaluazio kuantitatiboa. POTak eta 15 kontrol dituzten 61 pazientetan, hartzaile adrenergikoen (AR) aurkako autoantigorputzak alfa1 (anti-a1AR), beta1 (anti-b1AR) eta beta2 (anti-b2AR) eta antigorputz antinuklearrak kuantifikatzen ditugu.Emaitzak: Artikulazioen hiperlaxotasuna eta neke kroniko-fibromialgiaren sindromea nabarmen ohikoagoak izan ziren POTSean. Alde esanguratsuak ikusten ditu-gu proba autonomiko kardiobaskularretan, EParen igoera handiagoarekin, inklinazio-testean 3 minutura TPR txikiagoa eta BRS handiagoa. AR anti-gorputzak nabarmen altuagoak izan ziren POTean ( % 62) kontroletan baino ( % 17), antigorputz positibodun POT guztietan anti-a1ARekin alderatuta; POTen % 21,1ek anti-a1AR konbinazioa zuen beste AR antigorputz batzue-kin. Palpitazioen eta intolerantzia ortostatikoaren presentzia nabarmen han-diagoa izan zen anti-AR positiboak izan zituzten kasuetan.Ondorioa: Gure emaitzek iradokitzen dute anti-AR antigorputzen prebalentzia nabarmen handiagoa dela POTSen, eta antigorputz horien mailak lotutako sintomen presentziarekin lotzen dira.

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