PMID- 30693486
OWN - NLM
STAT- MEDLINE
DCOM- 20190523
LR  - 20221207
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 139
IP  - 5
DP  - 2019 May
TI  - Autoantibodies in acquired myasthenia gravis: Clinical phenotype and 
      immunological correlation.
PG  - 428-437
LID - 10.1111/ane.13071 [doi]
AB  - 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 AND METHODS: Patients of MG (n = 85, 
      M:F::1.1:1, 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.
CI  - (c) 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Nagappa, Madhu
AU  - Nagappa M
AUID- ORCID: 0000-0002-6682-4577
AD  - Department of Neurology, National Institute of Mental Health and Neurosciences 
      (NIMHANS), Bangalore, India.
AD  - Neuromuscular Laboratory (NML), Neurobiology Research Centre (NBRC) National 
      Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
FAU - Mahadevan, Anita
AU  - Mahadevan A
AD  - Neuromuscular Laboratory (NML), Neurobiology Research Centre (NBRC) National 
      Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
AD  - Department of Neuropathology, National Institute of Mental Health and 
      Neurosciences (NIMHANS), Bangalore, India.
FAU - Gangadhar, Yashwanth
AU  - Gangadhar Y
AD  - Neuromuscular Laboratory (NML), Neurobiology Research Centre (NBRC) National 
      Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
AD  - Department of Neuropathology, National Institute of Mental Health and 
      Neurosciences (NIMHANS), Bangalore, India.
FAU - Patil, Shripad A
AU  - Patil SA
AUID- ORCID: 0000-0001-6909-658X
AD  - Department of Neuromicrobiology, National Institute of Mental Health and 
      Neurosciences (NIMHANS), Bangalore, India.
FAU - Bokolia, Suresh
AU  - Bokolia S
AD  - Department of Neuromicrobiology, National Institute of Mental Health and 
      Neurosciences (NIMHANS), Bangalore, India.
FAU - Bindu, Parayil S
AU  - Bindu PS
AD  - Department of Neurology, National Institute of Mental Health and Neurosciences 
      (NIMHANS), Bangalore, India.
AD  - Neuromuscular Laboratory (NML), Neurobiology Research Centre (NBRC) National 
      Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
FAU - Sinha, Sanjib
AU  - Sinha S
AD  - Department of Neurology, National Institute of Mental Health and Neurosciences 
      (NIMHANS), Bangalore, India.
FAU - Taly, Arun B
AU  - Taly AB
AD  - Department of Neurology, National Institute of Mental Health and Neurosciences 
      (NIMHANS), Bangalore, India.
AD  - Neuromuscular Laboratory (NML), Neurobiology Research Centre (NBRC) National 
      Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
LA  - eng
GR  - NIMH/PROJ-IMFS/AHR/2013/14/Intramural grant from the National Institute of Mental 
      Health and Neurosciences (NIMHANS), Bangalore, India/
PT  - Journal Article
DEP - 20190219
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
RN  - 0 (Autoantibodies)
RN  - 0 (Autoantigens)
RN  - 0 (Connectin)
RN  - 0 (Receptors, Cholinergic)
RN  - 0 (Ryanodine Receptor Calcium Release Channel)
RN  - 0 (TTN protein, human)
RN  - EC 2.7.10.1 (MUSK protein, human)
RN  - EC 2.7.10.1 (Receptor Protein-Tyrosine Kinases)
SB  - IM
MH  - Adult
MH  - Asian People
MH  - Autoantibodies/*immunology
MH  - Autoantigens/immunology
MH  - Cohort Studies
MH  - Connectin/immunology
MH  - Enzyme-Linked Immunosorbent Assay
MH  - Female
MH  - Humans
MH  - India
MH  - Male
MH  - Middle Aged
MH  - Myasthenia Gravis/*immunology
MH  - Phenotype
MH  - Receptor Protein-Tyrosine Kinases/immunology
MH  - Receptors, Cholinergic/immunology
MH  - Ryanodine Receptor Calcium Release Channel/immunology
MH  - Young Adult
OTO - NOTNLM
OT  - acetylcholine receptor
OT  - muscle-specific kinase
OT  - myasthenia gravis
OT  - ryanodine receptor
OT  - titin
EDAT- 2019/01/30 06:00
MHDA- 2019/05/24 06:00
CRDT- 2019/01/30 06:00
PHST- 2018/06/29 00:00 [received]
PHST- 2018/12/25 00:00 [revised]
PHST- 2019/01/04 00:00 [accepted]
PHST- 2019/01/30 06:00 [pubmed]
PHST- 2019/05/24 06:00 [medline]
PHST- 2019/01/30 06:00 [entrez]
AID - 10.1111/ane.13071 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2019 May;139(5):428-437. doi: 10.1111/ane.13071. Epub 2019 Feb 
      19.