POTS: New Horizons, New Frontiers

Dr. Blair Grubb's presentation at Johns Hopkins explores the potential autoimmune and auto-inflammatory mechanisms underlying POTS (Postural Orthostatic Tachycardia Syndrome). Emerging research suggests that autoantibodies, particularly against alpha-1 adrenergic and muscarinic receptors, might play a significant role in POTS pathogenesis, especially post-viral onset. Grubb highlights the prevalence of bleeding disorders, such as Delta granule storage disease, in POTS patients, suggesting platelet dysfunction as a cofactor. Actual cases including those with POTS following COVID-19 infections are being investigated for similar immunological markers. Furthermore, he discusses the overlap of POTS with neurocardiogenic syncope and heart rhythm abnormalities, utilizing tools like implantable monitors for accurate diagnosis. Preliminary treatment successes with immunotherapy, like IVIG, point towards promising management avenues, though the approach calls for caution due to potential side effects.