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- Yuki Kitazaki, Masamichi Ikawa, Toru Kishitani, Tomoko Kamisawa, Shunya Nakane, Yasunari Nakamoto, and Tadanori Hamano.
- Department of Neurology, Fukui-ken Saiseikai Hospital, Japan.
- Intern. Med. 2021 Jul 15; 60 (14): 2307-2313.
AbstractThis report describes a 59-year-old woman who presented with progressive encephalomyelitis with rigidity and myoclonus (PERM)-like symptoms and severe dysautonomia, including orthostatic hypotension, sinus bradycardia, dysuria, and prolonged constipation. Her neurological symptoms improved after immunotherapy, but the dysautonomia persisted. Anti-ganglionic acetylcholine receptor (gAChR) α3 subunit antibodies, which are frequently identified in patients with autoimmune autonomic ganglionopathy, were detected in the pre-treatment serum. The central distribution of the nicotinic acetylcholine receptors, a target of anti-gAChR antibodies, and immunotherapeutic efficacy observed in this case indicate that anti-gAChR α3 subunit antibodies are associated with the PERM-like features accompanied by autonomic manifestations.
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