Successful treatment of postural orthostatic tachycardia and mast cell activation syndromes using naltrexone, immunoglobulin and antibiotic treatment.
| Autor: | Weinstock LB; Medicine, Washington University, Saint Louis, Missouri, USA.; Gastroenterology, Specialists in Gastroenterology, Saint Louis, MO, USA., Brook JB; Biostatistics, Private Practice, Anchorage, Alaska, USA., Myers TL; Gastrointestinal Department, Specialists in Gastroenterology, Saint Louis, Missouri, USA., Goodman B; Department of Neurology, Mayo Clinic Arizona, Scottsdale, Arizona, USA. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2018 Jan 11; Vol. 2018. Date of Electronic Publication: 2018 Jan 11. |
| DOI: | 10.1136/bcr-2017-221405 |
| Abstrakt: | A patient with severe postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome (MCAS) received immunotherapy with low-dose naltrexone (LDN) and intravenous immunoglobulin (IVIg) and antibiotic therapy for small intestinal bacterial overgrowth (SIBO). A dramatic and sustained response was documented. The utility of IVIg in autoimmune neuromuscular diseases has been published, but clinical experience with POTS is relatively unknown and has not been reported in MCAS. As a short-acting mu-opioid antagonist, LDN paradoxically increases endorphins which then bind to regulatory T cells which regulate T-lymphocyte and B-lymphocyte production and this reduces cytokine and antibody production. IVIg is emerging as a promising therapy for POTS. Diagnosis and treatment of SIBO in POTS is a new concept and appears to play an important role. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.) |
| Databáze: | MEDLINE |
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