Maintenance therapy with subcutaneous immunoglobulin in a patient with immune-mediated neuropathic postural tachycardia syndrome

J Transl Autoimmun. 2021 Aug 14:4:100112. doi: 10.1016/j.jtauto.2021.100112. eCollection 2021.

Abstract

Aims: We describe the disease course of a 35-year-old female with an autoimmune mediated neuropathic postural tachycardia syndrome (PoTS), who responded to immunoglobulin therapy and stabilized on maintenance therapy with subcutaneous immunoglobulin (SCIg).

Methods: We provide longitudinal data of clinical scores, tilt-table results and antibody titers.

Results: Initial treatment with intravenous immunoglobulin caused infusion-related side-effects whereas SCIg was well tolerated and improved clinical symptoms and quality of life. Clinical improvement correlated with the reduction of serum antibody titers 22 months after first infusion.

Conclusions: These findings suggest that autoimmune-mediated neuropathic PoTS can be treated sufficiently with IVIg whereas SCIg minimizes side-effects.

Keywords: Autoimmunity; Neuropathic postural tachycardia syndrome; Small fiber neuropathy; Subcutaneous immunoglobulin.

Publication types

  • Case Reports