Evidence map›Paper›PMID 35482157›Full record

ReviewNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2022

Paraneoplastic autoimmune autonomic ganglionopathy as the first symptom of bladder cancer: a case report and review of literature.

Carmen de Rojas Leal, José María Lage-Sánchez, Javier Pinel-Ríos, Olmo León Plaza, Omar Hamad-Cueto, Maria Teresa Dawid de Vera, Marc Stefan Dawid-Milner

Abstract readCase ReportsReview
PubMed Publisher
In one paragraph

Review in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. A case of seropositive autoimmune autonomic ganglionopathy treated with rituximab: Case report and review of the literature.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Carmen de Rojas LealDepartment of Neurology, Hospital Universitario Virgen de La Victoria, Malaga, Spain. carmenderojasleal@hotmail.com.ORCID http://orcid.org/0000-0002-6114-4564
José María Lage-SánchezDepartment of Urology, Hospital Universitario Virgen de La Victoria, Malaga, Spain.ORCID http://orcid.org/0000-0003-1264-5423
Javier Pinel-RíosDepartment of Neurology, Hospital Universitario Virgen de La Victoria, Malaga, Spain.
Olmo León PlazaDepartment of Neurology, Hospital Universitario Virgen de La Victoria, Malaga, Spain.
Omar Hamad-CuetoDepartment of Neurology, Hospital Universitario Virgen de La Victoria, Malaga, Spain.
Maria Teresa Dawid de VeraDepartment of Pathology, Hospital Universitario Virgen de La Victoria, Malaga, Spain.
Marc Stefan Dawid-MilnerInstituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Malaga, Spain.
Hospital Clínico Universitario Virgen de la Victoria · ESInstituto de Investigación Biomédica de Málaga · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAutoimmune autonomic ganglionopathy is a rare, immune-mediated disorder associated with anti-ganglionic α3-subunit nicotinic acetylcholine receptor (anti-α3gAChR) antibodies, which bind to acetylcholine receptor in autonomic ganglia (parasympathetic and sympathetic) leading to autonomic failure. This disorder is mostly associated with viral infections, but it can also be associated with systemic malignancies. Here, we report the case of a paraneoplastic autonomic ganglionopathy as the first symptom of bladder cancer.

methodCase report.

resultsA 47-year-old man, without medical history of interest, stated to the emergency department for progressive blurry vision with eye and mouth dryness, constipation, and dizziness upon standing for the last 2 weeks. Orthostatic hypotension was demonstrated by a drop in 13.3 mmHg mean blood pressure (BP) from supine (100/60 mmHg) to 45° reclining sitting position (80/50 mmHg). Blood tests, chest X-ray, brain MRI, and electroneuronography were unremarkable. Electrochemical skin conductance was reduced. Serological examination was positive for anti-α3gAChR antibodies. A full-body CT scan revealed a bladder tumor, which was treated by transurethral bladder resection. The pathologic study demonstrated a low-grade non-muscle-invasive bladder urothelial carcinoma. After tumor resection, and treatment with intravenous immunoglobulins and corticoids, a gradually improvement was observed. Today, the patient remains asymptomatic.

conclusionSubacute panautonomic failure can be the first symptom for systemic malignancies. This case reports a paraneoplastic autonomic ganglionopathy as the first symptom of bladder cancer. This case highlights the importance of a systemic study to rule out the presence of cancer when autoimmune autonomic ganglionopathy is present.

Indexed as

Autoimmune DiseasesAutoimmune Diseases of the Nervous SystemAutonomic Nervous System DiseasesCarcinoma, Transitional CellPeripheral Nervous System DiseasesUrinary Bladder NeoplasmsAutoantibodiesGanglia, AutonomicHumansMaleMiddle AgedAutoantibodiesAnti-α3gAChR antibodiesAutonomicBladder cancerDysautonomiaGanglionopathyParaneoplastic

Identifiers

PMID35482157
OpenAlexW4224995947

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.