Objective: Describe a case of stiff person syndrome and positivity for acetylcholine receptors ganglionic neuronal antibodies, not reportes before in stiff person syndrome.

Background: Acetylcholine receptors Ganglionic Neuronal (AChRGN) antibodies (Ab) have been reported with autoimmune autonomic neuropathy and paraneoplastic syndromes linked to lung cancer and myastheniform syndromes but also in some muscular hyperexcitability states.

Method: We describe the case of a 64 year old woman with stiff person syndrome and positivity for acetylcholine receptors ganglionic neuronal antibodies, that can also be seen in muscular hyperexcitability conditions, as well as other paraneoplastic syndromes.

Results: The relevance of this report is the possible direct elevation of this antibody due to a direct immunological cause.

Conclusion: Acetylcholine receptors ganglionic neuronal antibodies have been reported with autoimmune autonomic neuropathy, and paraneoplastic syndromes linked to lung cancer and myastheniform syndromes, also in some muscular hyperexcitability states, but not in stiff person syndrome.

References: 1. Vernino S, Lennon VA. Neuronal Ganglionic Acetylcholine Receptor Autoimmunity. Ann NY Acad Sci. 2003 Sep; 998: 211-214 2. Watanabe E, Fujita T, Shimono M, Koike H, Yasumoto S, Hirose S. Recurrent autonomic and sensory neuropathy in a patient with antiganglionic acetylcholine receptor antibodies. eNeurologicalSci. 2018 Aug 23; 12: 36-38. 3. Damato V, Balint B, Kienzler AK, Irani S. The Clinical Features, Underlying Immunology, and Treatment of Autoantibody-Mediated Movement Disorders. Mov Disord. 2018 Sep; 33 (9): 1376-1389.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/stiff-person-syndrome-and-acethylcoline-receptors-ganglionic-neuronal-antibodies/