Autoimmune Gastrointestinal Dysmotility in a Patient With HIV Treated With Methylprednisolone and Pyridostigmine. Issue 7 (21st July 2021)

• Record Type: Journal Article
• Authors: Gromisch, Christopher M.; Machado, Mariana A.; Satyam, Venkata; Nunes, David
• Is Part Of: ACG Case Reports Journal. Volume 8:Issue 7(2021)
• Page Start: e00636
• Publication Date: 2021-07-21
• DOI: 10.14309/crj.0000000000000636
• Languages: English
• ISSNs: 2326-3253

Abstract

ABSTRACT: Primary autoimmune gastrointestinal dysmotility is a limited form of autoimmune dysautonomia, driven by antiganglionic autoantibodies (AGAs) against enteric neurons. AGAs are observed in other autoimmune diseases, such as Guillain-Barré syndrome, before the development onset of gastrointestinal symptoms. Here, we report a case of a 57-year-old woman with human immunodeficiency virus, who previously developed Guillain-Barré syndrome, presenting with 6 months of intestinal dysmotility. Diagnosis was made by detecting AGAs to ganglionic acetylcholine receptor, alpha-3 subunit, radiographic evidence of duodenal dysmotility, and exclusion of other causes. The patient received high-dose methylprednisolone with low-dose pyridostigmine, which led to significant improvement of symptoms.