ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016 ACR/ARHP Annual Meeting
    • 2015 ACR/ARHP Annual Meeting
    • 2014 ACR/ARHP Annual Meeting
    • 2013 ACR/ARHP Annual Meeting
    • 2012 ACR/ARHP Annual Meeting
    • 2011 ACR/ARHP Annual Meeting
    • 2010 ACR/ARHP Annual Meeting
    • 2009 ACR/ARHP Annual Meeting
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2068

Joint Hypermobility Syndrome and Postural Orthostatic Tachycardia Syndrome (HyPOTS)

Artan Kaso and Ali Askari, Rheumatology, University Hospital Case Medical Center, Cleveland, OH

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Autonomic disorders, fibromyalgia and hypermobility

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Session Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Research Focus

Session Type: Abstract Submissions (ACR)

Background/Purpose

Joint hypermobility syndrome (JHS) is a chronically disabling disorder manifested as a widespread musculoskeletal pain and/or fatigue, in the presence of generalized joint hypermobility. It is often masquerading as Fibromyalgia or Chronic fatigue syndrome. It is a condition that is often overlooked by clinicians.

Methods

Currently in our clinic, we have observed 25 patients between 22 and 58 yr who were diagnosed with JHS using the Brighton Criteria (1). All of them presented with one or more of these symptoms: chronic fatigue, generalized musculoskeletal pain (arthralgias and myalgias), pre-syncope, palpitations, dizziness caring the diagnosis of fibromyalgia. They do not have any Marfanoid features or certain types of Ehlers-Danlos syndrome or skin involvement.       

Out of 25 patients 16 (64%) had a positive diagnostic tilt table test consistent with the diagnosis of postural orthostatic tachycardia syndrome (POTS), 6 (24%) have not had a tilt table test done yet (financial, non compliance, etc) and 3 (12%) had a negative tilt table test.

  

Patient

Age

Gender

*Symptoms of Autonomic dysfunction

Tilt table test

1

22

F

+

+

2

39

F

+

+

3

38

F

+

+

4

28

F

+

+

5

32

F

+

Not done

6

40

F

+

–

7

37

F

+

+

8

28

F

+

+

9

32

F

+

+

10

48

F

+

–

11

36

F

+

+

12

32

F

+

+

13

38

F

+

+

14

39

F

+

+

15

36

F

+

+

16

35

F

+

–

17

35

F

+

Not done

18

26

F

+

+

19

33

F

+

Not done

20

22

F

+

+

21

36

F

+

Not done

22

33

F

+

+

23

55

F

+

+

24

58

F

+

Not done

25

28

F

+

Not done

* Patient presented with Symptoms of Autonomic dysfunction like, orthostatic hypotension, palpitation, dizziness, passing out, fatigue.

Results

We have noticed that most of these patients are young female with a mean age of 35 with a presentation consistent with fibromyalgia or chronic fatigue syndrome, however further work up showed presence of autonomic dysfunction clinically and confirmed by tilt table test in 64%. By applying standard of care treatment for POTS with fludrocrotison, increasing water and salt intake, using Ted Hose stocking, they showed improvement in their clinical presentation. 

Conclusion

We conclude that there is a selective group of patients with JHS who have autonomic dysfunction which can contribute to the clinical presentations of these patients. These patients frequently are misdiagnosed as having Fibromyalgia or Chronic fatigue syndrome.

We have acronymed this entity “HyPOTS”.  

Potential manifestations of autonomic dysfunction include cardiac dysrhythmias, postural orthostatic tachycardia syndrome, orthostatic hypotension and orthostatic intolerance. Mechanisms leading to such phenomena in JHS patients may include weakened vascular tissue elasticity and impaired peripheral vasoregulation as a consequence of adrenoceptor or neuronal abnormalities (6, 7).

The pathophysiological basis for these symptoms needs to be further explored.

IRB approval for chart review was gained from University Hospital Case Medical Center.


Disclosure:

A. Kaso,
None;

A. Askari,
None.

  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/joint-hypermobility-syndrome-and-postural-orthostatic-tachycardia-syndrome-hypots/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

Annual Meeting in Atlanta, Georgia

© COPYRIGHT 2019 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.