Gastrointestinal motor dysfunction in acquired selective cholinergic dysautonomia associated with infectious mononucleosis
Abstract
This report documents the disturbance in gastrointestinal motor function in a patient with selective cholinergic dysautonomia that occurred following acute infectious mononucleosis. Apart from the gut, other organs affected included the pupils, sweat glands, lacrimal and salivary glands, and urinary bladder. Autonomic function tests showed the preservation of sympathetic adrenergic functions in contrast to the generalized involvement of postganglionic parasympathetic and sympathetic cholinergic nerves, including denervation hypersensitivity of the pupil and urinary bladder to exogenous cholinergic agonists. Cardiac and abdominal vagal responses were abnormal. Colon myenteric plexus ganglion cells were normal by morphological and immunohistochemical studies, suggesting that the selective cholinergic dysautonomia was the most likely pathophysiologic process responsible for the observed motility disorder. This study documents the occurrence of selective cholinergic dysautonomia following a viral illness, the importance of the extrinsic neural control on the motor function of the gastrointestinal tract, and the usefulness of combined motility and autonomic function testing in the evaluation of patients with symptoms suggestive of gut dysmotility.
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Several post-infectious syndromes have been described, including selective cholinergic dysautonomia with GI dysmotility after infectious mononucleosis (Epstein-Barr virus) or influenza A.
“Several post-infectious syndromes have been described, including selective cholinergic dysautonomia with GI dysmotility after infectious mononucleosis (Epstein-Barr virus) or influenza A (Lukkarinen et al., 2010; Vassallo et al., 1991).”
From Autonomic nervous system and gastrointestinal manifestations with an emphasis on gastric dysfunction (2026) · cites this paper as Vassallo et al., 1991
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Norovirus-induced Gastroparesis
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Small sensory fibre dysfunction in selective cholinergic dysautonomia
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Disturbances of Gastrointestinal Motility and the Nervous System
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Autonomic Nervous System Dysfunction and the Gastrointestinal Tract
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Disturbances of Gastrointestinal Motility and the Nervous System
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Self-citationGastric dysmotility at the organ level in gastroparesis
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- Authors
- Vassallo, M., Camilleri, M., Caron, B. L., & Low, P. A.
- Affiliations
- Mayo Clinic (US)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 1991-01
- Volume
- 100
- Issue
- 1
- Pages
- 252-258
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1840693624
- Cited by
- 95
- References
- 39
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 2 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 2 · 2013: 5 · 2012: 4
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5p30dk034988-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 34988)
- National Center for Research Resources (RR-00585, M01RR000585)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Surgery › Congenital gastrointestinal and neural anomalies
- Keywords
- infectious mononucleosis, gastrointestinal motility disorders, denervation supersensitivity, myenteric plexus, vagal reflex, autonomic dysfunction
- MeSH terms
- Adult, Autonomic Nervous System Diseases, Cholinergic Fibers, Female, Gastrointestinal Motility, Humans, Infectious Mononucleosis, Myenteric Plexus
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