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Testing for Autoimmune Disorders

Dysautonomia and Gastrointestinal Dysmotility



Updated: June 2013
Published: December 2010

Overview

Mayo Clinic offers autoantibody evaluations that are tailored to detect all currently recognized IgG markers of autoimmune dysautonomia and gastrointestinal (GI) dysmotility. The ganglionic (alpha 3) acetylcholine receptor (AChR) autoantibody is the most commonly detected marker of autoimmune dysautonomia and is sometimes encountered with isolated GI dysmotility. This is the only autoantibody proven to cause dysautonomia, including GI dysmotility. Importantly, cancer is detected in up to 30% of patients with the alpha-3 AChR autoantibody.

Because no more than 50% of patients with idiopathic dysautonomia are seropositive for the ganglionic AChR antibody, even when the dysautonomia is severe and generalized, Mayo Clinic has developed and clinically validated comprehensive serological profiles for dysautnomia and GI dysmotility that include neural autoantibodies in addition to ganglionic AChR autoantibodies. The profiles include other cation channel IgGs (neuronal voltage-gated calcium channel, potassium channel complex and muscle acetylcholine receptor) as well as neuronal, glial and muscle nuclear or cytoplasmic IgGs (ANNA-1/anti-Hu, CRMP-5, amphiphysin, GAD65 and striational).

In addition, new diagnostic algorithms help you order the right test at the right time.

Useful For

Neurologists, Oncologists and Pediatricians

  • Test: Autoimmune Dysautonomia Evaluation, Serum
    • Investigating idiopathic dysautonomic symptoms
    • Directing a focused search for cancer
    • Investigating autonomic symptoms that appear in the course or wake of cancer therapy and are not explainable by recurrent cancer or metastasis
    • Differentiating autoimmune dysautonomia from the effects of chemotherapy
  • Algorithm: Autoimmune Dysautonomia Evaluation

Gastroenterologists and Oncologists

  • Test: Autoimmune Gastrointestinal Dysmotility Evaluation, Serum
    • Investigating a patient with idiopathic GI dysmotility, limited or generalized
    • Investigating unexplained weight loss, anorexia, nausea, vomiting, constipation, diarrhea, early satiety, bloating or oropharyngeal thrush, particularly in a patient with past or family history of cancer or autoimmunity
    • Directing a focused search for cancer investigating gastrointestinal symptoms that appear in the course or wake of cancer therapy and are not explainable by recurrent cancer, metastasis or therapy
    • Differentiating autoimmune GI dysmotility from the effects of chemotherapy
    • Detecting early evidence of cancer recurrence in previously seropositive patients who have a rising titer of 1 or more autoantibodies
  • Algorithm: Gastrointestinal Dysmotility Evaluation

Test Results and Consultations

  • Mayo Clinic’s laboratory-based, physician-directed consultation service interprets the significance of the identified autoantibodies in the context of dysautonomia or GI dysmotility and cancer likelihood and type
  • For all positive results, full reference citations are included in our report and Mayo Clinic consultant physicians are available to personally discuss the individual patient with the ordering physician

Clinical References

  1. Vernino S, Low PA, Fealey RD, et al: Autoantibodies to ganglionic acetylcholine receptors in autoimmune autonomic neuropathies. N Engl J Med 2000;343:847-855
  2. O’Suilleabhain P, Low PA, Lennon VA: Autonomic dysfunction in the Lambert-Eaton myasthenic syndrome: serologic and clinical correlates. Neurology 1998;50:88-93
  3. Dhamija R, Tan KM, Pittock SJ, et al: Serological profiles aiding the diagnosis of autoimmune gastrointestinal dysmotility. Clin Gastroenterol Hepatol 2008;6:988-992
  4. McKeon A, Lennon VA, Lachance DH, et al: The ganglionic acetylcholine receptor autoantibody: oncological, neurological and serological accompaniments. Arch Neurol 2009 June;66(6):735-741

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