Autoantibodies Blocking M3 Muscarinic Receptors Cause Postganglionic Cholinergic Dysautonomia
Annals of neurology, 2020•Wiley Online Library
A 10‐year‐old girl presented with ileus, urinary retention, dry mouth, lack of tears, fixed
dilated pupils, and diffuse anhidrosis 7 days after a febrile illness. We hypothesized that her
syndrome was due to autoimmunity against muscarinic acetylcholine receptors, blocking
their activation. Using an indirect enzyme‐linked immunosorbent assay for all 5 muscarinic
receptors (M1–M5), we identified in the patient's serum antibodies that selectively bound to
M3 receptors. In vitro functional studies confirmed that these autoantibodies selectively …
dilated pupils, and diffuse anhidrosis 7 days after a febrile illness. We hypothesized that her
syndrome was due to autoimmunity against muscarinic acetylcholine receptors, blocking
their activation. Using an indirect enzyme‐linked immunosorbent assay for all 5 muscarinic
receptors (M1–M5), we identified in the patient's serum antibodies that selectively bound to
M3 receptors. In vitro functional studies confirmed that these autoantibodies selectively …
A 10‐year‐old girl presented with ileus, urinary retention, dry mouth, lack of tears, fixed dilated pupils, and diffuse anhidrosis 7 days after a febrile illness. We hypothesized that her syndrome was due to autoimmunity against muscarinic acetylcholine receptors, blocking their activation. Using an indirect enzyme‐linked immunosorbent assay for all 5 muscarinic receptors (M1–M5), we identified in the patient's serum antibodies that selectively bound to M3 receptors. In vitro functional studies confirmed that these autoantibodies selectively blocked M3 receptor activation. Thus, autoantibodies against M3 acetylcholine receptors cause acute postganglionic cholinergic dysautonomia. ANN NEUROL 2020;88:1237–1243
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