Evidence map›Paper›PMID 41668453›Full record

ArticleAnnals of medicine2026

Hives in autonomic disorders: a cutaneous marker of a distinct symptom phenotype.

Chatuthanai Savigamin, Tae Chung, Alison W Rebman, Yanni Larsen, Elizabeth Clark, Erica Cerquetti, Christina Kokorelis, Pegah Dehghan, Peter C Rowe, Brittany L Adler

Abstract read
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Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Chatuthanai SavigaminDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.
Tae ChungDepartment of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Alison W RebmanDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.
Yanni LarsenDepartment of Molecular & Cell Biology, Johns Hopkins University, Baltimore, MD, USA.
Elizabeth ClarkDepartment of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Erica CerquettiDepartment of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Christina KokorelisDepartment of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Pegah DehghanDepartment of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Peter C RoweDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Brittany L AdlerDivision of Rheumatology, Johns Hopkins University, Baltimore, MD, USA.ORCID 0000-0001-9912-2435

Funding

Post-Infectious Dysautonomia: Insights into Clinical Phenotypes and Disease PathogenesisK23AI180356 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Brittany Lee Adler · 2025 to 2026
$397k
NIAID NIH HHS K23 AI180356
6 · The paper itself

Abstract

backgroundPostural Orthostatic Tachycardia Syndrome (POTS) and Neurally-Mediated Hypotension (NMH) are heterogeneous syndromes characterized by dysautonomia and multisystem symptoms. Mast cell activation, often manifesting as hives, has been proposed as a contributing mechanism, but its prevalence and clinical relevance in POTS and NMH are poorly defined.

methodPatients from the Johns Hopkins POTS Clinic completed surveys assessing hives frequency and symptom burden using the Malmö POTS, the Composite Autonomic Symptom Score (COMPASS)-31, and a pain questionnaire. Associations between hives and clinical features were evaluated among patients with confirmed POTS, NMH, or clinically diagnosed orthostatic intolerance.

resultAmong 188 respondents, 80 (42.6%) reported hives sometimes and 33 (17.6%) reported hives often or always. Increasing hives frequency was associated with higher Malmö POTS scores and greater autonomic symptom burden across multiple COMPASS-31 subdomains, including gastrointestinal, bladder, and vasomotor symptoms (all

conclusionHives are common in orthostatic intolerance syndromes and are associated with increased symptom burden. Future studies are needed to clarify the role of mast cell activation and evaluate mast cell-targeted therapies.

Indexed as

Autonomic Nervous System DiseasesHypotension, OrthostaticPostural Orthostatic Tachycardia SyndromeAdultFemaleHumansMaleMast CellsMiddle AgedPhenotypePrevalenceSurveys and QuestionnairesSymptom Burdenhivesmast cell activation syndromeorthostatic intolerancePostural orthostatic tachycardia Syndromeurticaria

Identifiers

PMID41668453
PMCPMC12895873

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.