Sekhri Shaina, Massey Benson, Beniwal-Patel Poonam
Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
ACG Case Rep J. 2022 Jun 27;9(6):e00796. doi: 10.14309/crj.0000000000000796. eCollection 2022 Jun.
Autoimmune gastrointestinal dysmotility (AGID) is a rare form of limited autoimmune dysautonomia caused by autoantibodies against the enteric nervous system. Our patient was a 53-year-old man with 1 year of bloating, intolerance of oral intake, and recurrent ileus. Esophageal manometry showed aperistalsis and hypotensive lower sphincter, consistent with scleroderma esophagus. However, because the patient had no other sequelae of this disease, AGID was considered. Serologic evaluation revealed ganglionic acetylcholine receptor autoantibodies. Treatment with pyridostigmine led to resolution of symptoms. Early recognition of AGID should be considered when manometry shows scleroderma esophagus in patients without other evidence of systemic sclerosis.
自身免疫性胃肠动力障碍（AGID）是一种罕见的局限性自身免疫性自主神经功能障碍，由针对肠神经系统的自身抗体引起。我们的患者是一名53岁男性，有1年的腹胀、口服不耐受和反复肠梗阻病史。食管测压显示无蠕动和下括约肌低血压，符合硬皮病食管表现。然而，由于该患者没有这种疾病的其他后遗症，故考虑为AGID。血清学评估发现神经节乙酰胆碱受体自身抗体。使用吡啶斯的明治疗后症状缓解。当测压显示硬皮病食管而患者无其他系统性硬化证据时，应考虑早期识别AGID。
