Neurogenic Bladder Dysfunction Caused by Seronegative Autoimmune Autonomic Ganglionopathy.
- Author:
Sang Hyun KIM
1
Author Information
1. Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. sanghyunkim71@yahoo.com
- Publication Type:Case Report
- Keywords:
Primary dysautonomias;
Urinary bladder, neurogenic;
Autoimmune autonomic ganglionopathy
- MeSH:
Bethanechol;
Fever;
Follow-Up Studies;
Humans;
Immunoglobulins;
Parasympathetic Nervous System;
Plasmapheresis;
Primary Dysautonomias;
Sensation;
Skin;
Urinary Bladder;
Urinary Bladder, Neurogenic*;
Urodynamics
- From:Soonchunhyang Medical Science
2015;21(1):40-43
- CountryRepublic of Korea
- Language:Korean
-
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.
