Pathogenesis and Individualized Treatment for Postural Tachycardia Syndrome in Children.
OBJECTIVE
Postural tachycardia syndrome (POTS) is one of the major causes of orthostatic intolerance in children. We systematically reviewed the pathogenesis and the progress of individualized treatment for POTS in children.


METHODS
The data analyzed in this review are mainly from articles included in PubMed and EMBASE.


METHODS
The original articles and critical reviews about POTS were selected for this review.


RESULTS
Studies have shown that POTS might be related to several factors including hypovolemia, high catecholamine status, abnormal local vascular tension, and decreased skeletal muscle pump activity. In addition to exercise training, the first-line treatments mainly include oral rehydration salts, beta-adrenoreceptor blockers, and alpha-adrenoreceptor agonists. However, reports about the effectiveness of various treatments are diverse. By analyzing the patient's physiological indexes and biomarkers before the treatment, the efficacy of medication could be well predicted.


CONCLUSIONS
The pathogenesis of POTS is multifactorial, including hypovolemia, abnormal catecholamine state, and vascular dysfunction. Biomarker-directed individualized treatment is an important strategy for the management of POTS children.
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Wen-Rui
WR
Xu
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Hong-Fang
HF
Jin
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Jun-Bao
JB
Du
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002395:Catecholamines / Q000378:metabolism; D006801:Humans; D054972:Postural Orthostatic Tachycardia Syndrome / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology* / Q000628:therapy
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D002395:Catecholamines