Autoimmune Gastrointestinal Paralysis: Failure of Conventional Treatment without Immunomodulation
Joint Authors
Weinkauf, Craig
McPhillips, Sean
Krouse, Robert
Levine, Ira
Source
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-09-18
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
The treatment of the rare enteric nervous system (ENS) manifestations of paraneoplastic syndromes, which are most frequently associated with small cell lung cancer (SCLC), is poorly understood and described.
Patients with neuroendocrine-derived tumors can develop B-cell reactivity towards the tumor with cross-reactivity for neurons located in the submucosal and myenteric ganglia of the ENS.
The ensuing autoimmune neuritis causes aperistalsis and severe gastrointestinal (GI) dysfunction.
Immune-directed therapy is not the standard of care but may be paramount for patient recovery.
Our patient, a 63-year-old man with recent symptoms of esophageal dysmotility and newly diagnosed SCLC was hospitalized with nausea, emesis, and constipation.
After an extensive work-up that included laparoscopy and celiotomy with bowel resection, we diagnosed what we refer to as Autoimmune Paraneoplastic Chronic Intestinal Pseudoobstruction (AP-CIPO).
Unlike the few clinically similar reports, SCLC and AP-CIPO were diagnosed in our patient within weeks of each other, which presented the dilemma of treating the two processes simultaneously.
In this report, we review the relevant literature and describe our patient’s course.
We believe standard chemotherapy is not effective treatment for AP-CIPO.
Based on evidence discussed herein, we suggest initiating autoimmune-directed therapy before or simultaneous with cancer-directed therapy.
American Psychological Association (APA)
Weinkauf, Craig& McPhillips, Sean& Krouse, Robert& Levine, Ira. 2014. Autoimmune Gastrointestinal Paralysis: Failure of Conventional Treatment without Immunomodulation. Case Reports in Surgery،Vol. 2014, no. 2014, pp.1-4.
https://search.emarefa.net/detail/BIM-1017726
Modern Language Association (MLA)
Weinkauf, Craig…[et al.]. Autoimmune Gastrointestinal Paralysis: Failure of Conventional Treatment without Immunomodulation. Case Reports in Surgery No. 2014 (2014), pp.1-4.
https://search.emarefa.net/detail/BIM-1017726
American Medical Association (AMA)
Weinkauf, Craig& McPhillips, Sean& Krouse, Robert& Levine, Ira. Autoimmune Gastrointestinal Paralysis: Failure of Conventional Treatment without Immunomodulation. Case Reports in Surgery. 2014. Vol. 2014, no. 2014, pp.1-4.
https://search.emarefa.net/detail/BIM-1017726
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1017726