AChR myasthenia gravis switching to MuSK or double antibody positive myasthenia gravis in two children and literature review.


Journal

Neuromuscular disorders : NMD
ISSN: 1873-2364
Titre abrégé: Neuromuscul Disord
Pays: England
ID NLM: 9111470

Informations de publication

Date de publication:
07 2020
Historique:
received: 10 07 2019
revised: 14 02 2020
accepted: 23 03 2020
pubmed: 11 5 2020
medline: 12 8 2021
entrez: 11 5 2020
Statut: ppublish

Résumé

Muscle-specific tyrosine kinase antibody (MuSK-Ab) and acetylcholine receptor antibody (AChR-Ab) coexistence in myasthenia gravis (MG) is very rare. In this report, two children with AChR-Ab switching to double antibody positive MG (DP-MG) or MuSK-Ab positive MG (MuSK-MG) are described. Six similar cases were found in the literature via online database search. Therefore, this study describes eight patients in total, six female and two male. The average age of onset was 7.25 ± 5.95 years. Four AChR-MG patients switched to DP-MG with no known precipitating factor and four switched after thymectomy (two to MuSK-MG and two to DP-MG). After the serological switch, the patients transitioned to the phenotype of MuSK-MG and responded poorly to cholinesterase inhibitors and well to corticosteroids and plasma exchange.

Identifiants

pubmed: 32387283
pii: S0960-8966(20)30085-7
doi: 10.1016/j.nmd.2020.03.012
pii:
doi:

Substances chimiques

Autoantibodies 0
Cholinesterase Inhibitors 0
Receptors, Cholinergic 0
MUSK protein, human EC 2.7.10.1
Receptor Protein-Tyrosine Kinases EC 2.7.10.1

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

534-538

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Auteurs

Yaru Lu (Y)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Hao Ran (H)

School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, China.

Wenhao Yang (W)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Qian Ma (Q)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Li Qiu (L)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Changyi Ou (C)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Pei Chen (P)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Zhongqiang Lin (Z)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

Weibin Liu (W)

Department of Neurology, National Key Clinical Department and Key Discipline of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China. Electronic address: liuwb@mail.sysu.edu.cn.

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Classifications MeSH