In the literature, neo-nicotinic symptoms, other psychiatric symptoms and their electrocardiographic changes (sinus tachycardia, sinus bradycardia, supraventricular arrhythmia, ventricular arrhythmia, QT prolongation, and ST-T change) partially resemble rare cases of autoimmune disease, i.e. myasthenia gravis (MG) or autoimmune autonomic ganglionopathy (AAG) with neuropsychiatry symptoms or myocarditis, caused by nM level of anti-nAChR antibody [46–48]. The gene discussed is CHRNA4; the disease is myasthenia gravis.