Pediatric Anti-ganglionic Antibody Positive Autonomic Neuropathy: Clinical Presentation and Response to Treatment

BackgroundAutoimmune autonomic neuropathy is rare in children. There are few pediatric reports documenting anti-ganglionic antibodies.MethodsWe present two children with anti-ganglionic antibody positive autonomic neuropathy, including their presentation, results of testing, and treatment course.ResultsBoth children had delayed diagnoses because of the presence of vague autonomic symptoms. Treatment with multiple immunotherapies appears to bring at least a partial response and can be monitored with anti-ganglionic antibody titers.ConclusionOur findings contribute to the sparse literature in pediatric autoimmune autonomic neuropathy and highlight the need for additional studies to create diagnostic criteria and define optimal treatment regimens.