Successful Treatment of Postural Orthostatic Tachycardia and Mast Cell Activation Syndromes Using Naltrexone, Immunoglobulin, and Antibiotic Treatment

This 2018 case report describes a multimodal approach to treating a patient with concurrent postural orthostatic tachycardia syndrome (POTS) and mast cell activation syndrome (MCAS). The regimen included low-dose naltrexone (LDN), intravenous immunoglobulin (IVIg), and rifaximin for small intestinal bacterial overgrowth (SIBO). The patient reported significant symptom improvement across multiple