Is there a relationship between gluten sensitivity and postural tachycardia syndrome?
BACKGROUND
We have noticed that patients with postural tachycardia syndrome (PoTS) were placing themselves on a gluten-free diet without medical consultation. Therefore, we aimed to evaluate the prevalence of coeliac disease and self-reported gluten sensitivity in a cohort of patients with PoTS and compare this with local population data.


METHODS
A total of 100 patients with PoTS were recruited to complete a questionnaire that screened for gluten sensitivity, related symptoms and dietary habits. Patients were also assessed for coeliac disease. For comparison, the local coeliac prevalence was determined from a total of 1200 controls (group 1) and a further 400 controls (group 2), frequency matched for age and sex, who completed the same questionnaire.


RESULTS
Overall, 4/100 (4%) patients with PoTS had serology and biopsy-proven coeliac disease. This was significantly higher than the local population prevalence of coeliac disease (12/1200, 1%; odds ratio: 4.1, 95% confidence interval: 1.3-13.0; P=0.03). PoTS patients also had a higher prevalence of self-reported gluten sensitivity (42 vs. 19%, respectively; odds ratio: 3.1, 95% confidence interval: 2.0-5.0; P<0.0001) compared with age-matched and sex-matched controls.


CONCLUSIONS
This is the first study to suggest a potential association between gluten-related disorders and PoTS. A prospective study evaluating this relationship further may enable a better understanding and management of these conditions.
aAcademic Department of Gastroenterology Departments of bCardiology cRadiology dNeurology, Royal Hallamshire Hospital eUpperthorpe Medical Centre, Sheffield, UK.
Hugo A
HA
Penny
Imran
I
Aziz
Melloney
M
Ferrar
Jayne
J
Atkinson
Nigel
N
Hoggard
Marios
M
Hadjivassiliou
John N
JN
West
David S
DS
Sanders
D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D001706:Biopsy; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D016145:Endoscopy, Digestive System; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D054972:Postural Orthostatic Tachycardia Syndrome / Q000453:epidemiology*; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012307:Risk Factors; D057566:Self Report; D011795:Surveys and Questionnaires; D011503:Transglutaminases / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins