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Muscle Nerve. 2019 Jun 8. doi: 10.1002/mus.26609. [Epub ahead of print]
Association between MuSK antibody concentrations and the Myasthenia Gravis Composite Score in three patients: A marker of relapse ?
Triplett JD1, Hardy TA1, Riminton DS2, Chu SKY3, Reddel SW1.
Abstract
INTRODUCTION:
Muscle-specific tyrosine kinase (MuSK) autoantibody related myasthenia gravis is characterized by bulbar and respiratory manifestations, a poor response to anticholinergics and a generally good response to plasma exchange and rituximab. It is not known if MuSK-Ab levels could be used to predict the clinical course.
METHODS:
Three patients where frequent long-term monitoring of MuSK-Ab levels and the Myasthenia Gravis Composite score (MGC) were performed are described.
RESULTS:
A close relationship existed between the MuSK-Ab concentrations and the MGC. Furthermore, a rise in antibody concentration preceded a more serious clinical relapse in all patients.
DISCUSSIONS:
These findings suggest that MuSK-Ab concentrations may be a useful biomarker for the long-term monitoring of MuSK myasthenia gravis particularly while in clinical remission. This may allow preemptive escalation of therapy to prevent clinical relapse, and conversely permitting greater weaning of unnecessary immunosuppression.
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