Abstract Details

Title Serological and Clinical Profile of Antibody Positive Autoimmune Gastrointestinal Dysmotility Patients Receiving IVIg

Topic Autoimmune Neurology

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-108

Objective To describe the serological and clinical profile of antibody positive autoimmune gastrointestinal dysmotility patients receiving IVIg

Background Autoimmune gastrointestinal dysmotility (AGID) is a limited form of dysautonomia that can accompany other autonomic symptoms. As a relatively under-recognized condition, features of AGID are not well described in literature. Specifically, gut motility and transit times using SmartPill assessment have not been previously reported.

Design/Methods 20 adult antibody positive patients assessed in dysautonomia and gastric dysmotility clinic at the Cleveland Clinic were identified from an existing list of patients who have received or are currently receiving IVIg therapy. Serological, clinical, Smart Pill dysmotility, and autonomic testing data were recorded. Pearson correlation used to investigate correlation between antibody titers and dysmotility times.

Results Antibodies for GAD (14/20), voltage-gated potassium channel (6/20), N-type voltage gated calcium channel (3/20), acetylcholine receptor (3/20) and GM1 (1/20) were identified. Fifteen patients had coexisting autoimmune diagnoses including hypothyroidism, stiff person syndrome, Sjogren’s syndrome, type 1 diabetes, Crohn’s disease, lupus, celiac, CIDP, and HUS. Of 16 patients who underwent Smart Pill testing, 12 had abnormal testing. Specifically, 7 had prolonged whole gut transit duration, 8 had delayed gastric emptying, 7 had delayed small bowel transit, and 7 had delayed colonic transit. GAD titer did not correlate with gut transit times. While the two patients with most prolonged whole gut transit times both had multiple positive antibodies, this pattern was also inconsistent. Of 16 patients who underwent autonomic testing, 13 had abnormal results including 4 with abnormal tilt tables, 4 with abnormal Valsalva, 4 with abnormal skin nerve biopsy, 1 with abnormal QSART, and 1 with abnormal TST.

Conclusions AGID patients have a heterogeneous clinical and serological presentation requiring comprehensive autonomic evaluation. SmartPill testing is a valuable addition to assessment of these patients.

Authors/Disclosures
Chen Yan, MD (Cleveland Clinic) PRESENTER	Dr. Yan has nothing to disclose.
Greg Owendoff	Greg Owendoff has nothing to disclose.
Ryan M. Edelbrock	No disclosure on file
	No disclosure on file

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