Clinical phenotype of postural orthostatic tachycardia associated with anti-adrenergic receptor antibodies
- Fernández-Valle, Tamara 1
- Maria Ángeles Acera Gil 2
- Tijero, Beatriz 2
- Pérez-Concha, Tomás 3
- Del Pino, Rocío 4
- Murueta-Goyena, Ane 4
- Vicente-Lafuente, José 5
- Boyero, Sabas 6
- Ruiz-López, Marta 3
- Martínez-Alday, Jesús-Daniel 7
- Ugarte, Amaia 8
- Ruiz-Irastorza, Guillermo 8
- Ribacoba, Laureano 8
- López-de-Munain, Adolfo 9
- Gabilondo, Iñigo 10
- Gómez-Esteban, Juan-Carlos 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 (d) San Juan de Dios Hospital. Autonomic Center (NeuroTek). Santurtzi, Spain.
- 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 (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 (c) University of the Basque Country (UPV/EHU). Department of Neuroscience. Leioa, Spain.
- 6 (b) Basque Health Service-Osakidetza. Ezkerraldea-Enkarterri-Cruces Integrated Health Organization. Cruces University Hospital. Neurology Department, Barakaldo, Spain.
- 7 (f) Basque Health Service-Osakidetza. Bilbao-Basurto Integrated Health Organization. Cardiology Service. Arrhythmia Unit. Bilbao, Spain.
- 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 (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 (e) Ikerbasque: The Basque Foundation for Science. Bilbao, Spain.
ISSN: 0304-4858, 2173-2302
Any de publicació: 2023
Volum: 120
Número: 2
Pàgines: 66-73
Tipus: Article
Altres publicacions en: Gaceta médica de Bilbao: Revista oficial de la Academia de Ciencias Médicas de Bilbao. Información para profesionales sanitarios
Resum
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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