title: Autoimmune autonomic ganglionopathy: a possible postganglionic neuropathy.
abstract: OBJECTIVE
  To evaluate postganglionic autonomic and somatic nerve fiber involvement in a patient with chronic autoimmune autonomic ganglionopathy.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Department of Neurological Sciences, University Federico II of Naples.
  
  
  METHODS
  A patient with a 16-year history of severe autonomic failure and a high nicotinic acetylcholine receptor antibody titer underwent an extensive laboratory evaluation.
  
  
  METHODS
  Evaluation of sympathetic and parasympathetic functions and sural nerve and skin biopsies.
  
  
  RESULTS
  Clinical and laboratory evaluations showed the involvement of cardiovascular, pupillary, sudomotor, gastrointestinal, and bladder functions. Sudomotor function study and skin biopsy findings revealed postganglionic autonomic damage. Moreover, sural nerve and skin biopsy specimens provided clear evidence of somatic nerve fiber involvement.
  
  
  CONCLUSIONS
  We demonstrated postganglionic autonomic damage that could be related to a prolonged and severe impaired synaptic transmission and we report, for the first time to our knowledge, a somatic nerve fiber involvement in autoimmune autonomic ganglionopathy.
authors.affiliation: Department of Neurological Sciences, University Federico II of Naples, Italy.
authors.forename: Fiore
authors.initials: F
authors.lastname: Manganelli
authors.forename: Raffaele
authors.initials: R
authors.lastname: Dubbioso
authors.forename: Maria
authors.initials: M
authors.lastname: Nolano
authors.forename: Rosa
authors.initials: R
authors.lastname: Iodice
authors.forename: Chiara
authors.initials: C
authors.lastname: Pisciotta
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Provitera
authors.forename: Lucia
authors.initials: L
authors.lastname: Ruggiero
authors.forename: Luigi
authors.initials: L
authors.lastname: Serlenga
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Barbieri
authors.forename: Lucio
authors.initials: L
authors.lastname: Santoro
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000276:immunology; D005725:Ganglia, Autonomic / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011115:Polyneuropathies / Q000175:diagnosis* / Q000276:immunology; D017779:Sympathetic Fibers, Postganglionic / Q000473:pathology*