Orthostatic Intolerance -- a syndrome including neurally mediated hypotension,
delayed orthostatic hypotension, and postural orthostatic tachycardia syndrome
-- is found in almost all adolescents with CFS:
- Rowe, PC. General Information Brochure on Orthostatic Intolerance and
its Treatment. Chronic Fatigue Clinic, Johns Hopkins Children's Center, February 2003
- Rowe, PC. Orthostatic
intolerance and chronic fatigue syndrome: New light on an old problem.
J Pediatr. 2002 Apr;140(4):387-9.
- Rowe PC,
Bou-Holaigah I, Kan J, Calkins H: Is neurally mediated hypotension an
unrecognized cause of chronic fatigue? Lancet. 1995 Mar
11;345(8950):623-4.
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We conclude that chronic fatigue syndrome is highly related to orthostatic intolerance in adolescents.
The orthostatic intolerance of CFS often has heart rate and BP responses similar to responses in the syndrome of orthostatic tachycardia suggesting that a partial autonomic defect may contribute to symptomatology in these patients."
~ Julian Stewart, MD, PhD
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Rowe PC, Barron DF,
Calkins H, Maumenee IH, Tong PY, Geraghty MT: Orthostatic intolerance
and chronic fatigue syndrome associated with Ehlers-Danlos syndrome.
The Journal of Pediatrics. October 1999; 135(4).
- Tanaka H, Matsushima R, Tamai H, Kajimoto Y.
Impaired postural
cerebral hemodynamics in young patients with chronic fatigue with and without orthostatic
intolerance. J Pediatr. 2002 Apr;140(4):412-7.
-
Stewart JM, Gewitz MH, Weldon A, Arlievsky N, Li K, Munoz J. Orthostatic
Intolerance in Adolescent Chronic Fatigue Syndrome. Pediatrics. 1999
January; 103(1): 116-121.
-
Stewart JM, Gewitz MH, Weldon A, Munoz J: Patterns of orthostatic intolerance:
the orthostatic tachycardia syndrome and adolescent chronic fatigue. J
Pediatr 1999 Aug;135(2 Pt 1):218-25.
-
Stewart JM, Weldon
A, Arlievsky N, Li K, Munoz J: Neurally mediated hypotension and
autonomic dysfunction measured by heartrate variability during head-up
tilt testing in children with chronic fatigue syndrome. Clin Auton
Res. 1998 Aug;8(4):221-30.
- Stewart JM.
Autonomic nervous system dysfunction in adolescents with postural
orthostatic tachycardia syndrome and chronic fatigue syndrome is
characterized by attenuated vagal baroreflex and potentiated
sympathetic vasomotion. Pediatr Res. 2000
Aug;48(2):218-26.
- Massin MM, Leroy P. A 9-year-old girl with chronic fatigue. Diagnosis:
neurally mediated hypotension. Eur J Pediatr 1999
Sep;158(9):761-2.
- Karas
B, Grubb BP, Boehm K, Kip K: The postural orthostatic tachycardia
syndrome: a potentially treatable cause of chronic fatigue, exercise
intolerance, and cognitive impairment in adolescents. Pacing Clin
Electrophysiol 2000 Mar;23(3):344-51.
- Stewart JM, Weldon A.
Inappropriate
early hypotension in adolescents: a form of chronic orthostatic intolerance
with defective dependent vasoconstriction.
Pediatr Res. 2001 Jul;50(1):97-103.
- Shichiri M, Tanaka H, Takaya R, Tamai H.
Efficacy
of high sodium intake in a boy with instantaneous orthostatic hypotension.
Clin Auton Res 2002 Feb;12(1):47-50 .
- Stewart JM, Weldon A.
Vascular
perturbations in the chronic orthostatic intolerance of the postural
orthostatic tachycardia syndrome. J Appl Physiol.
2000 Oct;89(4):1505-12.
- Stewart JM. Pooling
in chronic orthostatic intolerance: arterial vasoconstrictive but not venous
compliance defects. Circulation. 2002 May 14;105(19):2274-81.
- Stewart JM. Orthostatic intolerance in pediatrics.
J Pediatr. 2002 Apr;140(4):404-11. No abstract available.
- Stewart JM. Orthostatic
hypotension in pediatrics. Heart Dis. 2002 Jan-Feb;4(1):33-9.
Review.
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