Multiple Myeloma Presenting with Autoimmune Autonomic Ganglionopathy

Intern Med. 2017 Dec 15;56(24):3347-3351. doi: 10.2169/internalmedicine.9096-17. Epub 2017 Oct 11.

Abstract

Autoimmune autonomic ganglionopathy is an autonomic disorder that occurs as a symptom of paraneoplastic neurological syndrome. To date, there have been no reports on multiple myeloma with autoimmune autonomic ganglionopathy. A 37-year-old Japanese woman suffered from orthostatic hypotension was diagnosed with multiple myeloma (IgG kappa type), and a serological examination revealed the presence of anti-ganglionic nicotinic acetylcholine receptor (anti-gAChR) antibodies. She was treated for multiple myeloma, as a result, the autonomic disturbance improved and her anti-gAChR antibody titer decreased to undetectable levels, despite the fact that she only achieved a partial remission of multiple myeloma. Treatment for multiple myeloma may improve autoimmune autonomic ganglionopathy.

Keywords: autoimmune autonomic ganglionopathy; autonomic disturbance; multiple myeloma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoantibodies / immunology
  • Autonomic Nervous System Diseases / complications*
  • Female
  • Ganglia, Autonomic / pathology*
  • Humans
  • Multiple Myeloma / complications*
  • Receptors, Nicotinic / immunology

Substances

  • Autoantibodies
  • Receptors, Nicotinic