Soonchunhyang Med Sci.  2015 Jun;21(1):40-43. 10.0000/sms.2015.21.1.40.

Neurogenic Bladder Dysfunction Caused by Seronegative Autoimmune Autonomic Ganglionopathy

• Kim SH

• KMID: 1797811
• DOI: http://doi.org/10.0000/sms.2015.21.1.40

Abstract

Autoimmune autonomic ganglionopathy is a form of acquired autonomic failure affecting parasympathetic, sympathetic functions, usually affecting healthy young people. The disorder affects both sympathetic and parasympathetic nervous systems, with acute onset, monophasic course, and partial recovery with relative preservation of motor and sensory function. We experienced a case of young man with acute autoimmune autonomic ganglionopathy who developed voiding difficulty, sudden blurred vision and gastrointestinal discomfort without motor or sensory dysfunction. Fever developed 5 days earlier and persisted until onset of autonomic failure. Patient complained voiding difficulty and urodynamic study revealed detrusor are flexia with failure to initiate and sustain adequate detrusor contraction. Sympathetic skin response and several autonomic function tests showed abnormalities. Intravenous immunoglobulin was applied for 5 days but symptoms persisted. Thus, 5 days of plasmapheresis treatment was followed showing improvements in most of the symptoms. However bladder dysfunction persisted at 6 months follow-up, showing partial recovery at bethanechol administration.

Keyword

Primary dysautonomias; Urinary bladder, neurogenic; Autoimmune autonomic ganglionopathy

MeSH Terms

Bethanechol
Fever
Follow-Up Studies
Humans
Immunoglobulins
Parasympathetic Nervous System
Plasmapheresis
Primary Dysautonomias
Sensation
Skin
Urinary Bladder
Urinary Bladder, Neurogenic*
Urodynamics
Bethanechol
Immunoglobulins