Have Postural Orthostatic Tachycardia Syndrome From Lupus. Taking Plaquenil. Is It A Poor Prognosis?

Posted on Wed, 6 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 6 Nov 2013 Answered on

Sat, 23 Nov 2013 Last reviewed on

Question : I have Postural Orthostatic Tachycardia syndrome from Lupus (thats what the doc says anyway). i only take plaquenil since Lupus gave me POTS is that a poorer prognosis since its the nervous system (i heard if it affects CNS its bad)? I dont have much joint pain and my kidneys are fine so far. biggest complaint is POts

Answered by Dr. Het Ram Bishnoi (7 hours later)

Brief Answer: Postural Tachycardia syndrome. Detailed Answer: Hello XXXXXXX Postural Orthostatic Tachycardia Syndome or POTS at the age of 27 years chances of recovery is very good. Prognosis is not bad; more than 80 % patients improve and 1/4 resumes their work as exercise and sports. Plaquenil ( hydroxyxhloroqine ) is good for lupus , take it regularly. Atenolol is beta blocker and recommended for POTS. Expansion of fluid volume and postural training will help you. In my opinion consult a physiotherapist ( trained in cardiology) and get his consultation for postural training. Also consult a cardiologist and get his help. Hope this information will help . If you have any other questions, I will be glad to help. Dr. HET

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Het Ram Bishnoi (27 minutes later)

i guess im asking since POTS is a nervous system problem and if they are saying my lupus caused it does that mean that i have a poor lupus prognosis ? i read somewhere that if lupus affects your nervous system that its a poor prognosis in the end for the patient, please advise.

Answered by Dr. Het Ram Bishnoi (47 minutes later)

Brief Answer: Prognosis in lupus. Detailed Answer: Hello, XXXXXXX Approximately half of the pots patients report on antecedent viral infection (may be in your case). Lupus may or may not the cause of POTS. The most common manifestation of diffuse CNS lupus is cognitive dysfunction , particularly difficulties with memory & reasoning. Headaches are also common too. Besides these seizures of any type, myopathy and psychosis are few other common manifestation. Further poor prognosis is associated serum creatinine level above 1.4 mg/dl (.124 micromol/L). Therefore I wouldn't label you as poor prognosis. Survival in patient with lupus is 90-95 % 2 years, 82-90% at 5 years, 71-80% at 10 years, & 63-75% at 20 years. Moreover I would not confirm that you got POTS only from lupus. Hope this information will help you. Further queries are welcome. Good luck Dr. HET

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Het Ram Bishnoi (15 minutes later)

my POTSstarted after a bad pregnancy i had a placental abruption and then literally 2 weeks after giving birth I got POTS... i remember the day it all happened so they say pregnancy caused it but then 4 months after that I got lupus. i just assumed it was all connected to lupus before pregnancy i was fine

Answered by Dr. Het Ram Bishnoi (20 minutes later)

Brief Answer: Lupus prognosis. Detailed Answer: Hello, XXXXXXX As I said in my POTS may or may not be due to lupus. Since we do not have a test to confirm the relation between POTS and lupus, you may be right in assuming lupus as the cause. Now, back to your question as I wrote if your kidneys are perfectly alright and you don't have other CNS symptoms, prognosis of lupus is still good. Hope this helps. Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Het Ram Bishnoi (11 minutes later)

thanks a bunch - this is a crazy world we live in .

Answered by Dr. Het Ram Bishnoi (2 minutes later)

Brief Answer: Welcome Detailed Answer: Hello XXXXXXX It is my pleasure to answer . God bless you long healthy life . Good luck for all family members. Dr. HET

Above answer was peer-reviewed by : Dr. Prasad