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This occurs in peripheral circulation and can promote symptoms such as postural orthostatic tachycardia syndrome (PoTS), PEM, fatigue, endothelial cell dysfunction, platelet hyperactivation, mast cell activation, and connective tissue disorders

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Cytotoxic edema is partly associated with the early release of glutamate and accumulation of ions and osmotically active solutes, and with failure of the active ion pumps in the neurons and glia