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Myasthenia gravis with muscle‐specific tyrosine kinase antibodies: A narrative review
Author(s) -
Morren John,
Li Yuebing
Publication year - 2018
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26107
Subject(s) - myasthenia gravis , plasmapheresis , acetylcholine receptor , rituximab , medicine , antibody , neuromuscular junction , tyrosine kinase , immunology , pharmacology , gastroenterology , receptor , biology , neuroscience
Growing evidence provides new insights about myasthenia gravis (MG) with antibodies against muscle‐specific tyrosine kinase (MuSK‐MG), including its pathogenesis, clinical and electrophysiological manifestations, and treatment. Data now support the presence of both presynaptic and postsynaptic dysfunction in MuSK‐MG. This is 1 of many key differences between MuSK‐MG and acetylcholine receptor antibody‐MG (AChR‐MG), especially as it pertains to potential therapeutic implications. In comparison to AChR‐MG, MuSK‐MG is generally more refractory to treatment. However, because MuSK‐MG is better understood and more readily recognized today, there are more reports of a relatively benign course. The most effective immunotherapies for MuSK‐MG are corticosteroids, plasmapheresis, and rituximab. With appropriate therapy, most patients with MuSK‐MG achieve minimal manifestation status or better on the postintervention status outlined by the Myasthenia Gravis Foundation of America. A minority of patients remain refractory to treatment, and optimal management for this group remains a considerable challenge. Muscle Nerve 58 : 344–358, 2018