When POTS is the tip of the iceberg: Rare cases of dysautonomia as a possible manifestation of another disorder.

This study by Svetlana Blitshteyn discusses how POTS can sometimes be one manifestation of rare underlying conditions like Fabry disease, McArdle disease, mitochondrial disease, carcinoid tumor, Hodgkin's lymphoma, and chemotherapy-induced neuropathy. It presents case studies of six patients, showing that symptoms of POTS may precede the diagnosis of these conditions by months or years. Importantly, treating the underlying condition can lead to significant improvement or resolution of POTS symptoms. Clinicians should be alert to atypical features in POTS patients which may indicate an alternative diagnosis and guide further investigation into other possible underlying disorders.