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Incidence ofAutoimmune Autonomic Ganglionopathy in ME/CFS

Discussion in 'General ME/CFS Discussion' started by kangaSue, Nov 17, 2015.

  1. kangaSue

    kangaSue Senior Member

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    Brisbane, Australia
    I'm looking into Autoimmune Autonomic Ganglionopathy as the underlying cause for my chronic G.I. dysfunctions, i.e. Gastroparesis, Chronic Mesenteric Ischemia and Chronic Intestinal Pseudo-obstruction of the small bowel. I fit symptomatically for AAG after recently being diagnosed with Restricted Autonomic Neuropathy in an autonomic function test panel but haven't had the antibody test for a3-nAChR which should confirm it, except you can also be seronegative and still have AAG.

    I don't have ME/CFS myself but I see that AAG has been known to occur in some with ME/CFS. It falls in to the category of a channelopathy which can occur in chronic conditions, be that from inflammation or because of ion channel antibodies.

    I'm not computer savvy enough to compile a poll but I'm interested in knowing how many here with ME/CFS has been tested for AAG. The symptoms seem to have a large overlap with those often discussed in connection with autonomic dysfunction in ME/CFS, i.e. orthostatic hypotension or POTS, gastrointestinal dysmotility, anhidrosis, bladder dysfunction, sicca symptoms, impaired pupillary light reflex, brain fog.

    Everything I read says this is a rare condition, I have asked a couple of doctors about it before but it was quickly dismissed as, according to most of the literature, AAG is usually described as involving a rapid onset of symptoms but latest research makes a case for it to be also seen as a slowly progressive disorder, a restricted form of AAG where a low antibody count to a3-nAChR is found and this has been found to be the cause of gastroparesis as a stand alone autonnomic dysfunction of G.I. dysmotility.

    http://www.hindawi.com/journals/ad/2013/549465/
    http://archneur.jamanetwork.com/article.aspx?articleid=785281
     
  2. Battery Muncher

    Battery Muncher Senior Member

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    Looks interesting. I'll have a look when I have the energy.
     
  3. kangaSue

    kangaSue Senior Member

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    Brisbane, Australia
    I was reading through this thread http://forums.phoenixrising.me/inde...acetylcholine-toxicity-the-cause-of-cfs.9757/ and it struck me that Autoimmune Autonomic Ganglionopaathy could also fit the bill as one of the factors to do with an apparent acetylcholine toxicity, it would explain why some say they get symptomatic relief from delaying the breakdown of acetylcholine.

    Pyridostigmine is one of the treatment options for AAG and I don't think any one would be surprised to know that Rituximab is one of the newer treatments being used to decrease the levels of antibodies in AAG.
     

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