Autoimmune Gastrointestinal Dysmotility: Symptoms, Pathogenesis and Treatment
Autoimmune Gastrointestinal Dysmotility: Symptoms, Pathogenesis and Treatment
Autoimmune gastrointestinal dysmotility syndromes are poorly understood, and often difficult
 to treat because the underlying pathogenesis is unclear. Refractory symptoms result in an
 impaired quality of life. The presence of positive serum autoantibodies to peripheral nervous
 system gangliosides and glycoproteins is suggestive of a possible mechanism. Immunomodulator
 treatments have shown benefit in case reports and case series but standardized data for
 treatment response is lacking. Therefore, our primary aims are to further characterize this
 syndrome in terms of symptoms, laboratory testing, pathology, and assess treatment response
 of immunomodulator therapy. Our research plan involves identifying this subset of patients
 with autoimmune gastrointestinal dysmotility and dysautonomia, and studying them as they are
 managed by their gastroenterologists. We will administer symptom-based questionnaires in a
 systematic manner to assess the clinical trajectory of this population and treatment
 response. We will also analyze laboratory values (antibody titers, tilt testing, inflammatory
 markers) and study pathology specimens (enteric and skin biopsies) obtained from this cohort
 to gain a deeper understanding of the pathogenesis of their disease.
Inclusion Criteria:

 -  Males and females, Aged>15

 -  Evidence of enteric dysmotility with documented abnormality on objective testing which
 may include high resolution esophageal manometry, gastric emptying scintigraphy,
 SmartPill Wireless Motility Capsule, Sitz marker studies, antroduodenal manometry or
 anorectal manometry.

 -  English proficiency and literacy sufficient to sign consent form and fill out
 questionnaires.

 -  Previous Mayo paraneoplastic panel testing.

 -  Referring gastroenterologist has recommended intravenous immunoglobulin (IVIg)
 therapy.

 Exclusion Criteria:

 -  Non-autoimmune causes of enteric dysmotility (diabetes, adrenal insufficiency,
 Parkinson's, thyroid, electrolytes, drugs, malignancy).

 -  Pregnancy as documented in EPIC with serum or urine Human chorionic gonadotropin (hCG)
 testing

 -  If participants believe that they are pregnant, they will need to notify a study
 physician who will order a serum or urine hCG test for pregnancy within EPIC and
 remove them from the study if the test results come back positive.

 -  Previous treatment with IVIg.