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Multiple antibody detection in ‘seronegative’ myasthenia gravis patients
Author(s) -
Hong Y.,
Zisimopoulou P.,
Trakas N.,
Karagiorgou K.,
Stergiou C.,
Skeie G. O.,
Hao H.J.,
Gao X.,
Owe J. F.,
Zhang X.,
Yue Y.X.,
Romi F.,
Wang Q.,
Li H.F.,
Gilhus N. E.,
Tzartos S. J.
Publication year - 2017
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.13300
Subject(s) - myasthenia gravis , antibody , medicine , radioimmunoassay , immunology , acetylcholine receptor , autoimmune disease , autoantibody , gastroenterology , receptor
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 ( AC hR) and muscle‐specific kinase (Mu SK ) 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 AC hR and Mu SK antibodies. These samples were screened by (i) a novel, highly sensitive radioimmunoassay for AC hR antibodies; (ii) cell‐based assays for clustered AC hR, Mu SK and lipoprotein receptor‐related protein 4 ( LRP 4) antibodies; (iii) a radioimmunoassay for titin antibodies. Results Antibodies to AC hR, Mu SK , LRP 4 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. AC hR antibody positive patients had more severe disease ( P = 0.008) and a trend towards fewer remissions/minimal manifestations than AC hR 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.