Postural tachycardia syndrome following human papillomavirus vaccination

Background and purposePostural tachycardia syndrome (POTS) is a heterogeneous disorder of the autonomic nervous system that may have an autoimmune etiology. MethodsSix patients who developed new onset POTS 6days to 2months following human papillomavirus vaccination are reported. ResultsThree patients also had neurocardiogenic syncope, and three patients were diagnosed with possible small fiber neuropathy. Symptoms in all patients improved over 3years with pharmacotherapy and non-pharmacological measures but residual symptoms persisted. Molecular mimicry with formation of cross-reacting autoantibodies to the potential targets of the autonomic ganglia, neurons, cardiac proteins or vascular receptors is considered as a possible pathogenesis of new onset POTS after immunization. ConclusionCorrect diagnosis of POTS and awareness that POTS may occur after vaccination in young women is essential for prompt and effective management of this condition.