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Autoantibody‐mediated bowel and bladder dysfunction in a patient with chronic, nondiabetic neuropathy
Author(s) -
Jackson Michael W.,
Gordon Thomas P.,
McCombe Pamela A.
Publication year - 2008
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.20946
Subject(s) - autoantibody , medicine , peripheral neuropathy , dysautonomia , antibody , immunology , diabetes mellitus , myasthenia gravis , autonomic nerve , gastroenterology , endocrinology , disease
Physiological techniques can be used to detect novel autoantibodies causing alteration of autonomic function after passive transfer to mice. Previously, such antibodies have been detected in patients with type I diabetes mellitus, myasthenia gravis, and Sjogren's syndrome. We now describe a patient with an idiopathic nondiabetic neuropathy with prominent autonomic symptoms, including bladder and bowel dysfunction. Physiological assays of whole colon and bladder were used to determine the presence in the patient serum of functional autoantibodies capable of mediating autonomic dysfunction. Immunoglobulin G (IgG) from this patient was able to disrupt bladder and bowel function on passive transfer to mice. This is a new pattern of autoantibody‐mediated abnormality. Although the target antigen is unknown, it is likely to be a cell‐surface receptor or ion channel. This case highlights the usefulness of passive transfer studies in detecting functional antibodies in patients with autonomic neuropathy. Muscle Nerve, 2007