Complete remission with histamine blocker in a patient with intractable hyperadrenergic postural orthostatic tachycardia syndrome secondary to long coronavirus disease syndrome.

Journal of hypertension 2024 May 01

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The COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), has emerged as a global public health concern and its sequels have barely started to outcrop. A good percentage of patients who suffered from COVID-19 are prone to develop long-COVID or post-COVID condition (PCC), a multisystemic, heterogeneous, chronic disorder. Patients with PCC may experience diverse manifestations, of which cardiovascular and neurological symptoms are among the most frequently reported. Indeed, dysautonomia presented as orthostatic intolerance has gained room following recent reports linking postural orthostatic tachycardia syndrome (POTS) with PCC. Disturbances in heart rate (HR) and blood pressure (BP) during postural changes are the cornerstones of orthostatic intolerance seen in patients suffering from PCC. A subtype of POTS, hyperadrenergic POTS, has been widely studied because of its association with mast cell activation syndrome (MCAS). Although a causative relationship between PCC, hyperadrenergic POTS, and MCAS remains unrevealed, these syndromes can overlap. We want to propose here a correlation produced by a close-loop mechanism with positive feedback established after SARS-CoV-2 infection in a previously healthy young patient. Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.

Citation

Felipe González-Alvarez, Bruno Estañol, Jesús Antonio González-Hermosillo, Francisco Javier Gómez-Pérez, Karla Maria Tamez-Torres, Eduardo Peña, Carlos Cantú, Erwin Chiquete, José Sifuentes-Osornio, Maria Del Carmen Alba-Lorenzo, Dulce Andrea Celestino-Montelongo, Guadalupe E Salazar-Calderón, Jose de Jesus Aceves Buendia. Complete remission with histamine blocker in a patient with intractable hyperadrenergic postural orthostatic tachycardia syndrome secondary to long coronavirus disease syndrome. Journal of hypertension. 2024 May 01;42(5):928-932