Medicine:Autoimmune gastrointestinal dysmotility

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Autoimmune gastrointestinal dysmotility
SpecialtyGastroenterology

Autoimmune gastrointestinal dysmotility (AGID) is an autoimmune disease autonomic neuropathy affecting the gastrointestinal organs and digestive system of the body. Dysmotility is when the strength or coordination of the esophagus, stomach or intestines muscles do not work as they should.[1]

Presentation

Associated illnesses

Often AGID is a symptom of other problems, including colon cancer, lupus, lung, breast, or ovarian carcinoma or thymoma. or other diseases.

Diagnosis

AGID is diagnosed with a complete medical history, exam of patients motility and with special blood tests looking for autoantibodies consistent with neurologic autoimmunity.[2] Blood tests included evaluations of immunofluorescence (neuronal nuclear and cytoplasmic antibodies), radioimmunoprecipitation assays (neuronal and muscle plasma membrane cation channel antibodies), and enzyme-linked immunosorbent assay (muscle striational antibodies). A finding, along with medical history, of ganglionic neuronal acetylcholine receptor and N-type voltage-gated calcium channel autoantibodies in the blood stream would result in a medically acceptable diagnosis of AGID.[3]

Treatment

Medications to relieve nausea and vomiting or to enhance mobility may be helpful, as may cholinesterase inhibitors. Immunotherapy and plasma exchange have also been reportedly effective.[4] Pyridostigmine is a pharmaceutical treatment option for patients with AGID.[3] In severe cases patients with AGID are required to abandon eating foods, requiring them to get nourishment through a process called parenteral nutrition, where the patient is fed via a permanent IV and the liquid nourishment is infused directly in the blood stream, as opposed to a feeding tube.[5]

References

  1. Bolen, Barbara Bradley. "Dysmotility" . About.com. Retrieved 14 January 2013.
  2. Dhamija, Radhika; Tan, K. Meng; Pittock, Sean J.; Foxx–Orenstein, Amy; Benarroch, Eduardo; Lennon, Vanda A. (2008). "Serologic Profiles Aiding the Diagnosis of Autoimmune Gastrointestinal Dysmotility". Clinical Gastroenterology and Hepatology 6 (9): 988–92. doi:10.1016/j.cgh.2008.04.009. PMID 18599359. 
  3. 3.0 3.1 Pasha, Shabana F.; Lunsford, Tisha N.; Lennon, Vanda A. (2006). "Autoimmune Gastrointestinal Dysmotility Treated Successfully with Pyridostigmine". Gastroenterology 131 (5): 1592–6. doi:10.1053/j.gastro.2006.06.018. PMID 17101331. 
  4. "Autoimmune gastrointestinal dysmotility | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program" (in en). https://rarediseases.info.nih.gov/diseases/12063/autoimmune-gastrointestinal-dysmotility. 
  5. "Total parenteral nutrition: MedlinePlus Medical Encyclopedia" (in en). https://medlineplus.gov/ency/patientinstructions/000177.htm. 

Further reading