Autoimmune autonomic ganglionopathy: Treatment by plasma exchanges and rituximab

Richard Imrich, Steven Vernino, Basil A. Eldadah, Courtney Holmes, David S. Goldstein

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


This case report describes successful treatment of autoimmune autonomic ganglionopathy (AAG) in a 74-year-old woman by total plasma exchanges (PLEX) and rituximab. Two series of PLEX temporarily, but dramatically improved orthostatic intolerance and hypotension and baroreflex function, in a manner inversely related to ganglionic neuronal nicotinic receptor antibody titer. After rituximab treatment, the antibody titer was decreased modestly but persistently, and the patient had symptomatic and clinical laboratory evidence of continued benefit for at least 10 months, supporting the autoimmune pathogenesis of AAG.

Original languageEnglish (US)
Pages (from-to)259-262
Number of pages4
JournalClinical Autonomic Research
Issue number4
StatePublished - Aug 2009


  • Autoimmune autonomic ganglionopathy
  • Plasma exchange
  • Pure autonomic failure
  • Rituximab

ASJC Scopus subject areas

  • Endocrine and Autonomic Systems
  • Clinical Neurology


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