Autoimmune and paraneoplastic autonomic neuropathies

Steven Vernino and Angela Vincent

in Autonomic Failure

Fifth edition

Published on behalf of Oxford University Press

Published in print May 2013 | ISBN: 9780198566342
Published online July 2013 | e-ISBN: 9780199666508 | DOI:
Autoimmune and paraneoplastic autonomic neuropathies

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Key points

Cancer patients may have autonomic dysfunction due to direct effects of the malignancy or due to remote effects mediated by the immune system. - Acute or subacute autonomic failure can result from an autoimmune ‘paraneoplastic’ response to tumour antigens that cross reacts with autonomic ganglia or nerves. - Paraneoplastic autonomic neuropathy can present as widespread autonomic failure or as isolated severe gastrointestinal dysmotility. - Autonomic failure can also occur as a non-paraneoplastic idiopathic autoimmune disorder specifically targeting autonomic nerves or ganglia. - Autonomic dysfunction is also commonly seen in patients with Lambert–Eaton myasthenic syndrome, autoimmune neuromyotonia or Morvan’s syndrome both with and without tumours. - Patients with autoimmune or paraneoplastic autonomic neuropathy may have specific serum autoantibodies. - Some cases of autoimmune autonomic neuropathy are caused by antibodies specific for ganglionic nicotinic acetylcholine receptors. - Experimental autoimmune animal models of autonomic neuropathy have been described.

Chapter.  8065 words.  Illustrated.

Subjects: Neurology ; Immunology

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