Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastroenterol. Sep 28, 2026; 32(36): 120568
Published online Sep 28, 2026. doi: 10.3748/wjg.120568
Published online Sep 28, 2026. doi: 10.3748/wjg.120568
Anti-glutamic acid decarboxylase autoimmunity presenting as chronic intestinal pseudo-obstruction with dysautonomia and late-onset autoimmune diabetes: A case report
Mohamed Kharief, Roz O’Byrne, Karl William, Mohammed Ali Hasabarsoul, Ashraf Morcos, Department of Gastroenterology, University Hospital Waterford, Waterford X91 ER8E, Ireland
Orla Tuohy, Department of Neurology, University Hospital Waterford, Waterford X91 ER8E, Ireland
Author contributions: Kharief M was primarily responsible for clinical data collection, case documentation, and drafting of the initial manuscript; O’Byrne R contributed substantially to data interpretation, manuscript structuring, and critical revision with significant intellectual input, particularly in contextualizing the autoimmune mechanisms and therapeutic implications; William K and Hasabarsoul MA contributed to the data interpretation and manuscript revision; Tuohy O provided neurological expertise and contributed to the discussion; Morcos A supervised the study and critically revised the manuscript; Kharief M, O’Byrne R, William K, Hasabarsoul MA, Tuohy O, and Morcos A contributed to the conception and design of the study; all authors have read and approved the final manuscript.
AI contribution statement: The manuscript was written by the authors based on clinical data, interpretation, and scientific expertise. However, ChatGPT were used strictly for language polishing and grammar correction to improve clarity and readability. No AI tools were involved in the generation of scientific content, study design, data analysis, or interpretation of results. No images or figures included in this manuscript were generated using AI tools.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Mohamed Kharief, MD, Department of Gastroenterology, University Hospital Waterford, Dunmore Road, Waterford X91 ER8E, Ireland. mohdkharief@gmail.com
Received: March 2, 2026
Revised: April 18, 2026
Accepted: June 10, 2026
Published online: September 28, 2026
Processing time: 172 Days and 18.3 Hours
Revised: April 18, 2026
Accepted: June 10, 2026
Published online: September 28, 2026
Processing time: 172 Days and 18.3 Hours
Core Tip
Core Tip: Chronic intestinal pseudo-obstruction is a rare and diagnostically challenging disorder that may be associated with autoimmune mechanisms. This case highlights anti-glutamic acid decarboxylase antibody-associated dysautonomia presenting with gastrointestinal dysmotility and evolving insulin-dependent diabetes mellitus. It underscores the importance of considering autoimmune etiologies in unexplained chronic intestinal pseudo-obstruction and demonstrates the potential benefit of immunomodulatory therapy, including corticosteroids, intravenous immunoglobulin, and rituximab, in achieving sustained clinical improvement.