Autoantibodies in acquired myasthenia gravis: Clinical phenotype and immunological correlation.
Acta Neurol Scand
; 139(5): 428-437, 2019 May.
Article
em En
| MEDLINE
| ID: mdl-30693486
ABSTRACT
BACKGROUND:
Data on antibody profile in myasthenia gravis (MG) from India are limited.OBJECTIVES:
To investigate antibody profile in patients with MG and their clinical correlates. PATIENTS ANDMETHODS:
Patients of MG (n = 85, MF1.11, mean age 39.29 ± 17.3 years, mean symptom duration 72.94 ± 91.8 months) were evaluated for clinical features, MG foundation of America (MGFA) score, response to treatment, and outcome at last follow-up. Antibodies to acetylcholine receptor (AChR), muscle-specific kinase (MUSK), titin and ryanodine receptor (RYR) were analysed using ELISA.RESULTS:
Based on the regional distribution of weakness, the cohort could be categorized as generalized 60, ocular 16 and oculo-bulbar 9. Sixty patients were followed up for a mean duration of 26.74 ± 13.8 months. Outcome at last follow-up was as follows remission-22, no remission-33 and dead-5. AChR and MUSK antibodies were detected in 58 and 8 patients, respectively. Frequency of generalized MG, worse MGFA score during the disease course and thymomatous histology significantly correlated with presence of AChR-antibodies, though outcome at last follow-up was comparable between AChR-antibody positive and negative groups. Patients with MUSK antibodies had oculo-bulbar or generalized MG and frequent respiratory crisis, but majority improved or remitted with treatment. Titin antibodies were detected in 31.8% and RYR antibodies in 32.9%. Their presence did not correlate with age at onset of MG, severity or presence of thymoma.CONCLUSION:
This report highlights the spectrum of antibodies in MG in an Indian cohort. AChR-antibody positivity correlated with clinical severity. Outcome was good in majority of MUSK antibody-positive MG. The role of other antibodies, complementary vs epiphenomenon, remains open.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Autoanticorpos
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Miastenia Gravis
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
Acta Neurol Scand
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Índia