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Electrophysiological findings in patients with low density lipoprotein receptor related protein 4 positive myasthenia gravis
Author(s) -
Nikolic A. V.,
Bojic S. D.,
Rakocevic Stojanovic V. M.,
Basta I. Z.,
Lavrnic D. V.
Publication year - 2016
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13081
Subject(s) - myasthenia gravis , medicine , electrophysiology , cardiology
Background and purpose The aim was to determine the electrophysiological profile of our cohort of low density lipoprotein receptor related protein 4 ( LRP 4) positive myasthenia gravis ( MG ) patients. Methods A repetitive nerve stimulation ( RNS ) test and jitter analysis using a concentric needle electrode were performed in 17 LRP 4 positive MG patients. The results were compared to 31 muscle‐specific tyrosine kinase (Mu SK ) positive and 28 acetylcholine receptor ( AC hR) positive MG patients. Results The RNS test was negative in almost all patients belonging to the LRP 4/seronegative and LRP 4/Mu SK groups. It was positive most frequently in the AC hR MG patients, especially those without anti‐ LRP 4 antibodies. The presence of anti‐ LRP 4 antibodies was connected to lower decrement values, whilst the independent presence of anti‐ AC hR or anti‐Mu SK antibodies was connected to higher decrement values. Lowest jitter was recorded in patients with LRP 4/seronegative MG . The highest percentage of pathological jitter analysis test results was present in Mu SK and AC hR MG patients. The isolate presence of anti‐ LRP 4 antibodies did not influence the mean consecutive difference values, whilst mean consecutive difference values were higher in the presence of anti‐ AC hR or anti‐Mu SK antibodies. Conclusions Low density lipoprotein receptor related protein 4 positive patients make a distinct MG subgroup with rarely detected pathological electrophysiological test results. The lack of influence of anti‐ LRP 4 antibodies on the different electrophysiological parameters brings into question the pathogenic role of anti‐ LRP 4 antibodies in MG .