Multiple antibody detection in 'seronegative' myasthenia gravis patients.

Abstract:

BACKGROUND AND PURPOSE:Myasthenia gravis (MG) is an autoimmune disease caused by antibody mediated impairment in the neuromuscular junction. Seronegative MG (SNMG) without antibodies against acetylcholine receptor (AChR) and muscle-specific kinase (MuSK) by routine assays accounts for about 20% of all MG patients. METHODS:Plasma from 81 Chinese MG patients previously found to be seronegative was tested by routine assays for AChR and MuSK antibodies. These samples were screened by (i) a novel, highly sensitive radioimmunoassay for AChR antibodies; (ii) cell-based assays for clustered AChR, MuSK and lipoprotein receptor-related protein 4 (LRP4) antibodies; (iii) a radioimmunoassay for titin antibodies. RESULTS:Antibodies to AChR, MuSK, LRP4 and titin were found in 25% (20/81), 4% (3/81), 7% (6/81) and 6% (5/78) of SNMG patients, respectively. In total, 37% of SNMG patients were found to be positive for at least one of the tested antibodies. AChR antibody positive patients had more severe disease (P = 0.008) and a trend towards fewer remissions/minimal manifestations than AChR antibody negative patients. The four patients with coexistence of antibodies had more severe disease, whilst the seronegative patients had milder MG (P = 0.015). CONCLUSIONS:Detection of multiple muscle antibodies by more sensitive assays provides additional information in diagnosing and subgrouping of MG and may guide MG treatment.

journal_name

Eur J Neurol

authors

Hong Y,Zisimopoulou P,Trakas N,Karagiorgou K,Stergiou C,Skeie GO,Hao HJ,Gao X,Owe JF,Zhang X,Yue YX,Romi F,Wang Q,Li HF,Gilhus NE,Tzartos SJ

doi

10.1111/ene.13300

subject

Has Abstract

pub_date

2017-06-01 00:00:00

pages

844-850

issue

6

eissn

1351-5101

issn

1468-1331

journal_volume

24

pub_type

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