Sinus node dysfunction in myelin oligodendrocyte glycoprotein–associated disorder (MOGAD) presenting with optic neuritis

The relationship between the dysregulation of the autonomic nervous system (ANS) and autoimmune disease progression is an emerging area of research. The ANS, composed of the sympathetic and parasympathetic divisions, is known to play a vital role in regulating immune mechanisms. For instance, increased sympathetic activity can promote proinflammatory effects, exacerbating underlying autoimmune conditions, whereas increased parasympathetic activity can have anti-inflammatory effects.1 This interplay can influence the course and severity of certain autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis.2 In addition, autoimmune processes can also lead to the demyelination of the ANS, leading to autonomic dysfunction and in extreme cases, hemodynamic compromise. Understanding the complex interactions between the ANS and autoimmune diseases is crucial for developing more targeted and effective treatment strategies.2