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2015 ; 94
(31
): e1265
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
GAD Antibodies as Key Link Between Chronic Intestinal Pseudoobstruction,
Autonomic Neuropathy, and Limb Stiffness in a Nondiabetic Patient: A
CARE-Compliant Case Report and Review of the Literature
#MMPMID26252289
Maier A
; Mannartz V
; Wasmuth H
; Trautwein C
; Neumann UP
; Weis J
; Grosse J
; Fuest M
; Hilz MJ
; Schulz JB
; Haubrich C
Medicine (Baltimore)
2015[Aug]; 94
(31
): e1265
PMID26252289
show ga
Chronic intestinal pseudoobstruction (CIP) can be a severe burden and even a
life-threatening disorder. Typically, several years of uncertainty are passing
before diagnosis. We are reporting the case of a young woman with a decade of
severe, progressive gastrointestinal dysmotility. Unusually, she had also
developed an autonomic neuropathy, and a stiff limb syndrome.In addition to
achalasia and CIP the young woman also developed neuropathic symptoms:
orthostatic intolerance, urinary retention, a Horner syndrome, and lower limb
stiffness. Careful interdisciplinary diagnostics excluded underlying infectious,
rheumatoid, metabolic or tumorous diseases.The detection of GAD (glutamic acid
decarboxylase) antibodies, however, seemed to link CIP, autonomic neuropathy, and
limb stiffness and pointed at an autoimmune origin of our patient's complaints.
This was supported by the positive effects of intravenous immunoglobulin. In
response to this therapy the body weight had stabilized, orthostatic tolerance
had improved, and limb stiffness was reversed.The case suggested that GAD
antibodies should be considered in CIP also in nondiabetic patients. This may
support earlier diagnosis and immunotherapy.
|Adult
[MESH]
|Antibodies/*blood
[MESH]
|Autonomic Nervous System Diseases/diagnosis/*etiology/therapy
[MESH]