TOPLINE

A small subset of patients with dermatomyositis developed postural orthostatic tachycardia syndrome (POTS). The condition was more common in those with the classic subtype of dermatomyositis.

METHODOLOGY

• Researchers conducted a cross-sectional study analyzing two databases at the University of Pennsylvania, Philadelphia, to assess how often POTS occurred in patients with dermatomyositis and to describe related clinical features.
• They reviewed records of 608 patients with dermatomyositis (median age at symptom onset, 49.29 years; 84.7% women).
• Patients diagnosed with POTS between January 2007 and November 2025 were identified. These patients had at least 3 months of unexplained orthostatic tachycardia and either a positive result for a tilt-table test or an increase of at least 30 beats/min in heart rate within 10 minutes of standing, without orthostatic hypotension.

TAKEAWAY

• Researchers identified POTS in 18 of 608 patients with dermatomyositis. POTS was diagnosed at a median of about 5 years after the diagnosis of dermatomyositis.
• All patients with both POTS and dermatomyositis were women. Patients with both conditions were younger at the onset of dermatomyositis symptoms than those without POTS (median age, 36.3 vs 49.8 years; P < .001).
• The classic subtype of dermatomyositis was more common in patients with POTS than in those without POTS (88.9% vs 53.1%; P = .003).
• POTS occurred more often in patients with classic dermatomyositis than in those with cutaneous lupus erythematosus (CLE; 4.9% vs 0%) or in those with both CLE and systemic lupus erythematosus (4.9% vs 0.6%; P < .05 for both). No autoantibody was significantly associated with POTS.

IN PRACTICE

“Given overlapping symptoms with DM [dermatomyositis], autonomic dysfunction may be underrecognized in DM populations, and evaluation of POTS in symptomatic patients should be considered,” the authors of the study wrote.

SOURCE

The study was led by Sarah Jun, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia. It was published online on July 15, 2026, as a research letter in JAMA Dermatology.

LIMITATIONS

The study was conducted at a single center. The cohort of patients who had both dermatomyositis and POTS was small. Researchers conducted a retrospective analysis of data collected prospectively, which restricted establishing cause-effect relationships.

DISCLOSURES

The study received funding from the National Institutes of Health and the US Department of Veterans Affairs Veterans Health Administration, Office of Research and Development and Biomedical Laboratory Research and Development. The authors did not report any conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.