{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:08:24Z","timestamp":1790467704823,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,7,20]],"date-time":"2014-07-20T00:00:00Z","timestamp":1405814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["DK71209"],"award-info":[{"award-number":["DK71209"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic gastrointestinal dysmotility greatly impacts the quality of life. Treatment options are limited and generally symptomatic. Neural autoimmunity is an under\u2010recognized etiology. We evaluated immunotherapy as an aid to diagnosing autoimmune gastrointestinal dysmotility (<jats:styled-content style=\"fixed-case\">AGID<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010three subjects evaluated at the <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>ayo <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>linic for suspected <jats:styled-content style=\"fixed-case\">AGID<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ugust 2006\u2013<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ebruary 2014) fulfilled the following criteria: (1) prominent symptoms of gastrointestinal dysmotility with abnormalities on scintigraphy\u2013manometry; (2) serological evidence or personal\/family history of autoimmune disease; (3) treated by immunotherapy on a trial basis, 6\u201312\u00a0weeks (intravenous immune globulin, 16; or methylprednisolone, 5; or both, 2). Response was defined subjectively (symptomatic improvement) and objectively (gastrointestinal scintigraphy\/manometry studies).<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Symptoms at presentation: constipation, 18\/23; nausea or vomiting, 18\/23; weight loss, 17\/23; bloating, 13\/23; and early satiety, 4\/23. Thirteen patients had personal\/family history of autoimmunity. Sixteen had neural autoantibodies and 19 had extra\u2010intestinal autonomic testing abnormalities. Cancer was detected in three patients. Preimmunotherapy scintigraphy revealed slowed transit (19\/21 evaluated; gastric, 11; small bowel, 12; colonic, 11); manometry studies were abnormal in 7\/8. Postimmunotherapy, 17 (74%) had improvement (both symptomatic and scintigraphic, five; symptomatic alone, eight; scintigraphic alone, four). Nine responders re\u2010evaluated had scintigraphic evidence of improvement. The majority of responders who were re\u2010evaluated had improvement in autonomic testing (six of seven) or manometry (two of two).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>This proof of principle study illustrates the importance of considering an autoimmune basis for idiopathic gastrointestinal dysmotility and supports the utility of a diagnostic trial of immunotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12391","type":"journal-article","created":{"date-parts":[[2014,7,21]],"date-time":"2014-07-21T00:59:05Z","timestamp":1405904345000},"page":"1285-1297","source":"Crossref","is-referenced-by-count":69,"title":["Immunotherapy trial as diagnostic test in evaluating patients with presumed autoimmune gastrointestinal dysmotility"],"prefix":"10.1111","volume":"26","author":[{"given":"E. P.","family":"Flanagan","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y. A.","family":"Saito","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. A.","family":"Lennon","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"},{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA"},{"name":"Department of Immunology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"McKeon","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"},{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. D.","family":"Fealey","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. A.","family":"Szarka","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. A.","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. E.","family":"Foxx\u2010Orenstein","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Scottsdale AZ USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. C.","family":"Fox","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. J.","family":"Pittock","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic Rochester MN USA"},{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,7,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.04.009"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.06.018"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(91)90593-A"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200009213431204"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.3.652"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-065X.2012.01144.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI17429"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.1485-04.2004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12030"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655202753416821"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2009.12.004"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0326"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(12)70093-5"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000256698.69121.45"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.4065\/70.2.113"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.90467.2008"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2008.01230.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-301068"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.1127"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531-8249(20010201)49:2<146::AID-ANA34>3.0.CO;2-E"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.10518"},{"key":"e_1_2_10_23_1","first-page":"1013","volume-title":"Manual of Clinical and Laboratory Immunology","author":"Vernino SKT","year":"2002"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.4065\/73.12.1161"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000312275.04260.a0"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-011-0876-1"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05851.x"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-04-0735"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23756"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31821f468f"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.12391","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.12391","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T15:47:41Z","timestamp":1696261661000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.12391"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,20]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1111\/nmo.12391"],"URL":"https:\/\/doi.org\/10.1111\/nmo.12391","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7,20]]}}}