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Would you consider using IVIG for POTS in the absence of any clear autoimmune condition or abnormal antibodies?

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4 Answers
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Neurology · Emory University School of Medicine

I completely agree with the answer above. It would be a pretty rare consideration, overall.

Recent placebo-controlled and blinded studies examining the efficacy of IVIG for idiopathic or antibody-associated (FGFR, TSHDS) small fiber neuropathy found no benefit of the treatment in terms of small fibe...

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Neurology · Massachusetts General Hospital

IVIG use for POTS patients is off-label and not FDA approved regardless of autoimmunity. The use of IVIG has been reported to be beneficial in a subgroup of POTS patients with suspicion of an autoimmune cause such as having positive relevant antibodies, in the setting of a known autoimmune disease o...

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Neurology · CWRU School of Medicine

Do I use IVIG in POTS in the absence of any CLEAR autoimmune condition or antibodies? The keyword here is CLEAR and my short answer is NO.

However, there are several shortcomings in my answer.

  1. What is a clear autoimmune condition? We do not have criteria to define it yet.
  2. What antibodies are we ta...

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Neurology · SUNY Downstate Health Sciences University

I just wanted to add this recent publication to update the discussion of this question:

Vernino et al., PMID 38311655

It is only a small trial and I think more data are needed. However, it does provide evidence to show that IVIG does not seem to be a beneficial treatment option for POTS.

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