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[A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children].
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Oct 18; 54(5):954-960.BD

Abstract

OBJECTIVE

To analyze the disease spectrums underlying orthostatic intolerance (OI) and sitting intolerance (SI) in Chinese children, and to understand the clinical empirical treatment options.

METHODS

The medical records including history, physical examination, laboratory examination, and imagological examination of children were retrospectively studied in Peking University First Hospital from 2012 to 2021. All the children who met the diagnostic criteria of OI and SI were enrolled in the study. The disease spectrums underlying OI and SI and treatment options during the last 10 years were analyzed.

RESULTS

A total of 2 110 cases of OI and SI patients were collected in the last 10 years, including 943 males (44.69%) and 1 167 females (55.31%) aged 4-18 years, with an average of (11.34±2.84) years. The overall case number was in an increasing trend over the year. In the OI spectrum, postural tachycardia syndrome (POTS) accounted for 826 cases (39.15%), followed by vasovagal syncope (VVS) (634 cases, 30.05%). The highest proportion of SI spectrum was sitting tachycardia (STS) (8 cases, 0.38%), followed by sitting hypertension (SHT) (2 cases, 0.09%). The most common comorbidity of OI and SI was POTS coexisting with STS (36 cases, 1.71%). The highest proportion of treatment options was autonomic nerve function exercise (757 cases, 35.88%), followed by oral rehydration salts (ORS) (687 cases, 32.56%), metoprolol (307 cases, 14.55%), midodrine (142 cases, 6.73%), ORS plus metoprolol (138 cases, 6.54%), and ORS plus midodrine (79 cases, 3.74%). The patients with POTS coexisting with VVS were more likely to receive pharmacological intervention than the patients with POTS and the patients with VVS (41.95% vs. 30.51% vs. 28.08%, χ2= 20.319, P < 0.01), but there was no significant difference in the proportion of treatment options between the patients with POTS and the patients with VVS.

CONCLUSION

POTS and VVS in children are the main underlying diseases of OI, while SI is a new disease discovered recently. The number of children with OI and SI showed an increasing trend. The main treatment methods are autonomic nerve function exercise and ORS. Children with VVS coexisting with POTS were more likely to take pharmacological treatments than those with VVS or POTS only.

Authors+Show Affiliations

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China. Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing 100191, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

36241239

Citation

Cui, Y X., et al. "[A 10-year Retrospective Analysis of Spectrums and Treatment Options of Orthostatic Intolerance and Sitting Intolerance in Children]." Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences, vol. 54, no. 5, 2022, pp. 954-960.
Cui YX, DU JB, Zhang QY, et al. [A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children]. Beijing Da Xue Xue Bao Yi Xue Ban. 2022;54(5):954-960.
Cui, Y. X., DU, J. B., Zhang, Q. Y., Liao, Y., Liu, P., Wang, Y. L., Qi, J. G., Yan, H., Xu, W. R., Liu, X. Q., Sun, Y., Sun, C. F., Zhang, C. Y., Chen, Y. H., & Jin, H. F. (2022). [A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children]. Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences, 54(5), 954-960.
Cui YX, et al. [A 10-year Retrospective Analysis of Spectrums and Treatment Options of Orthostatic Intolerance and Sitting Intolerance in Children]. Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Oct 18;54(5):954-960. PubMed PMID: 36241239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children]. AU - Cui,Y X, AU - DU,J B, AU - Zhang,Q Y, AU - Liao,Y, AU - Liu,P, AU - Wang,Y L, AU - Qi,J G, AU - Yan,H, AU - Xu,W R, AU - Liu,X Q, AU - Sun,Y, AU - Sun,C F, AU - Zhang,C Y, AU - Chen,Y H, AU - Jin,H F, PY - 2022/10/14/entrez PY - 2022/10/15/pubmed PY - 2022/10/19/medline KW - Children KW - Disease spectrum KW - Orthostatic intolerance KW - Sitting intolerance SP - 954 EP - 960 JF - Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences JO - Beijing Da Xue Xue Bao Yi Xue Ban VL - 54 IS - 5 N2 - OBJECTIVE: To analyze the disease spectrums underlying orthostatic intolerance (OI) and sitting intolerance (SI) in Chinese children, and to understand the clinical empirical treatment options. METHODS: The medical records including history, physical examination, laboratory examination, and imagological examination of children were retrospectively studied in Peking University First Hospital from 2012 to 2021. All the children who met the diagnostic criteria of OI and SI were enrolled in the study. The disease spectrums underlying OI and SI and treatment options during the last 10 years were analyzed. RESULTS: A total of 2 110 cases of OI and SI patients were collected in the last 10 years, including 943 males (44.69%) and 1 167 females (55.31%) aged 4-18 years, with an average of (11.34±2.84) years. The overall case number was in an increasing trend over the year. In the OI spectrum, postural tachycardia syndrome (POTS) accounted for 826 cases (39.15%), followed by vasovagal syncope (VVS) (634 cases, 30.05%). The highest proportion of SI spectrum was sitting tachycardia (STS) (8 cases, 0.38%), followed by sitting hypertension (SHT) (2 cases, 0.09%). The most common comorbidity of OI and SI was POTS coexisting with STS (36 cases, 1.71%). The highest proportion of treatment options was autonomic nerve function exercise (757 cases, 35.88%), followed by oral rehydration salts (ORS) (687 cases, 32.56%), metoprolol (307 cases, 14.55%), midodrine (142 cases, 6.73%), ORS plus metoprolol (138 cases, 6.54%), and ORS plus midodrine (79 cases, 3.74%). The patients with POTS coexisting with VVS were more likely to receive pharmacological intervention than the patients with POTS and the patients with VVS (41.95% vs. 30.51% vs. 28.08%, χ2= 20.319, P < 0.01), but there was no significant difference in the proportion of treatment options between the patients with POTS and the patients with VVS. CONCLUSION: POTS and VVS in children are the main underlying diseases of OI, while SI is a new disease discovered recently. The number of children with OI and SI showed an increasing trend. The main treatment methods are autonomic nerve function exercise and ORS. Children with VVS coexisting with POTS were more likely to take pharmacological treatments than those with VVS or POTS only. SN - 1671-167X UR - https://www.unboundmedicine.com/medline/citation/36241239/[A_10_year_retrospective_analysis_of_spectrums_and_treatment_options_of_orthostatic_intolerance_and_sitting_intolerance_in_children]_ DB - PRIME DP - Unbound Medicine ER -