Immunologic Research

, Volume 65, Issue 1, pp 282–284 | Cite as

Postural tachycardia syndrome (POTS) with anti-NMDA receptor antibodies after human papillomavirus vaccination

  • Svetlana BlitshteynEmail author
  • Jill Brook
Therapeutic Aspects in Autoimmunity


We describe a young woman who developed POTS with positive serum anti-NMDA receptor antibodies and no evidence of encephalitis after vaccination with HPV vaccine, Cervarix. Her symptoms improved significantly with immunomodulatory therapy and re-occurred after immunomodulatory therapy was stopped, suggesting an autoimmune etiology of POTS after vaccination.


Human papillomavirus vaccination Postural tachycardia syndrome Anti-NMDA receptor antibodies Orthostatic intolerance Plasmapheresis 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


  1. 1.
    Thieben MJ, Sandroni P, Sletten DM, et al. Postural orthostatic tachycardia syndrome: the Mayo Clinic experience. Mayo Clin Proc. 2007;82:308–13.CrossRefPubMedGoogle Scholar
  2. 2.
    Dalmau J, Lancaster E, Martinez-Hernandez E, et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol. 2011;10:63–74.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Blitshteyn S. Postural tachycardia syndrome following human papillomavirus vaccination. Eur J Neurol. 2014;21:135–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Brinth L, Thiebel AC, Pors K, Melson J. Suspected side effects to the quadrivalent human papilloma vaccine. Dan Med J. 2015;62:A5064.PubMedGoogle Scholar
  5. 5.
    Li H, Yu X, Liles C, et al. Autoimmune basis for postural tachycardia syndrome. J Am Heart Assoc. 2014;3:e000755. doi: 10.1161/JAHA.113.000755.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Dubey D, Hopkins S, Vernino S. M1 and M2 muscarinic receptor antibodies among patients with postural orthostatic tachycardia syndrome: potential disease biomarker. J Clin Neuromuscul Dis. 2016;17:99–180 Abstract.CrossRefGoogle Scholar
  7. 7.
    Dahan S, Tomljenovic L, Shoenfeld Y. Postural orthostatic tachycardia syndrome (POTS): a novel member of the autoimmune family. Lupus. 2016;25:339–42.CrossRefPubMedGoogle Scholar
  8. 8.
    Hendrickson JE, Tormey CA. Human papilloma virus vaccination and dysautonomia: consideration for autoantibody evaluation and HLA typing. Vaccine. 2016;34:4468.CrossRefPubMedGoogle Scholar
  9. 9.
    Blitshteyn S. Autoimmune markers and autoimmune disorders in patients with postural tachycardia syndrome (POTS). Lupus. 2015;24:1364–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Hofmann C, Baur M-O, Schroten H. Anti-NMDA receptor encephalitis after TdaP-IPV booster vaccination: cause or coincidence? J Neurol. 2011;258:500–1.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of NeurologyState University of New York at Buffalo School of Medicine and Biomedical SciencesBuffaloUSA
  2. 2.Department of PsychologyUniversity of California, Los AngelesLos AngelesUSA

Personalised recommendations