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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Dec 20, 2025; 15(4): 101459
Published online Dec 20, 2025. doi: 10.5662/wjm.v15.i4.101459
Published online Dec 20, 2025. doi: 10.5662/wjm.v15.i4.101459
Need for combined therapy for a rare case of autoimmune autonomic ganglionopathy: A case report
Elena Angeloudi, Maria Xanthopoulou, Aris Liakos, Eleni Gigi, Second Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki 54642, Greece
Maria Lima, Athanasios C Kalyvas, Maria Dimitriou, Panagiotis Ioannidis, Second Neurology Department, AHEPA University Hospital, Thessaloniki 54636, Greece
Serafeim C Kotoulas, Adult CF Unit, Pulmonary Department, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle University of Thessaloniki, Thessaloniki 57010, Greece
Author contributions: Angeloudi E, Xanthopoulou M, Liakos A, and Gigi E conceptualized the study; Angeloudi E, Xanthopoulou M, Liakos A, and Gigi E developed the methodology; Ioannidis P, Lima M, and Gigi E validated the findings; Angeloudi E, Xanthopoulou M, Liakos A, Gigi E, Kalyvas AC, and Ioannidis P conducted the investigation; Kalyvas AC, Dimitriou M, and Kotoulas SC provided resources; Angeloudi E, Xanthopoulou M, Kalyvas AC, Lima M, Kotoulas SC, and Dimitriou M curated the data; Angeloudi E prepared the original draft; Angeloudi E, Xanthopoulou M, Liakos A, Ioannidis P, and Gigi E reviewed and edited the manuscript; Liakos A, Ioannidis P, and Gigi E supervised the study.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
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).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Elena Angeloudi, MD, MSc, Research Scientist, Second Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Kon stantinoupoleos 49, Thessaloniki 54642, Greece. elena-angeloudi@hotmail.com
Received: September 18, 2024
Revised: February 9, 2025
Accepted: February 24, 2025
Published online: December 20, 2025
Processing time: 323 Days and 16.8 Hours
Revised: February 9, 2025
Accepted: February 24, 2025
Published online: December 20, 2025
Processing time: 323 Days and 16.8 Hours
Core Tip
Core Tip: This case highlights the potential benefit of combined immunoadsorption and rituximab therapy in refractory autoimmune autonomic ganglionopathy. Despite first-line therapy failure, the patient achieved significant long-term improvement, suggesting that a stepwise immunomodulatory approach may be necessary in resistant cases.