Laboratory assay overview
This test can be utilized for evaluating symptoms indicative of idiopathic dysautonomia or discerning between autoimmune dysautonomia and the consequences of chemotherapy in individuals undergoing cancer treatment and exhibiting autonomic symptoms. Autoimmune dysautonomia encompasses disorders affecting the autonomic nervous system's components, triggered by neural-specific IgG or effector T cells. It presents as idiopathic or paraneoplastic, with variable onset and severity. Pandysautonomia manifests gradually with symptoms like impaired pupillary light reflex, anhidrosis, orthostatic hypotension, cardiac arrhythmias, gastrointestinal dysmotility, sicca manifestations and bladder dysfunction. Limited dysautonomia confines symptoms to specific areas, often milder, including sicca manifestations, postural orthostatism, cardiac arrhythmias, bladder dysfunction or gastrointestinal dysmotilities. Diagnosis relies on identifying objective abnormalities via autonomic reflex testing, thermoregulatory sweat test or gastrointestinal motility studies. The most common autoantibody, the neuronal ganglionic alpha-3-acetylcholine receptor (AChR) autoantibody, directly affects dysautonomia severity. Patients with this autoantibody often have cancer, including small-cell lung carcinomas, thymoma, lymphoma and adenocarcinomas. Cancer risks stem from personal or family history, smoking or carcinogen exposure. Early cancer detection improves neurological outcomes. Autoantibodies to other proteins, like antineuronal nuclear antibody-type 1 (ANNA-1) and collapsin response-mediator protein-5 neuronal (CRMP-5-IgG), also mark dysautonomia, predicting specific neoplasms.