Postural orthostatic tachycardia syndrome (POTS) in a child with type 1 diabetes

摘要

There has been considerable concern that cardiac autonomic neuropathy, combined with nocturnal hypoglycaemia, may be linked with sudden deaths in young people with type 1 diabetes mellitus (T1DM).1 There is evidence for example that signs of subclinical cardiac or peripheral neuropathy are present in nearly half of adolescents with T1DM.2 However, other causes of neuropathy must also be considered in patients with T1DM. For example, primary postural orthostatic tachycardia syndrome (POTS) can be a significant cause of orthostatic symptoms in otherwise healthy young adults.3 It is characterised by marked tachycardia, but maintenance of blood pressure (BP) on standing, in contrast with orthostatic hypotension or loss of heart rate (HR) variability and bradycardia in classic diabetic neuropathy. We report a case of likely familial POTS with severe, disabling symptoms in a patient with well-controlled T1DM.