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Laboratory Test

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Anti–acetylcholine receptor antibody The anti–acetylcholine receptor (AChR) antibody (Ab) test is reliable for diagnosing autoimmune myasthenia gravis (MG). It is highly specific (as high as 100%, according to Padua et al).  [ 4 ]  Results are positive in as many as 90% of patients who have generalized MG but in only 50-70% of those who have only ocular MG; thus false negatives are common in cases of purely ocular MG. False-positive anti-AChR Ab test results have been reported in cases of thymoma without MG and in patients with  Lambert-Eaton myasthenic syndrome , small cell lung cancer, or rheumatoid arthritis treated with penicillamine, as well as in 1-3% of the population older than 70 years. Tindall reported AChR Ab results and mean Ab titers in a group of patients with MG (see the Table below).  [ 25 ]  Table. Prevalence and Titers of Antibody to Acetylcholine Receptor in Patients with Myasthenia Gravis  (Open Table in a new window) Os...
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Advance Treatments

Abstract and Introduction  Abstract Myasthenia gravis (MG) should be classified according to antibody status (acetylcholine, MuSK, LRP4, titin), thymus (hyperplasia, neoplasia, atrophy), age at debut (< or >50 years), symptom localization (generalized, ocular) and severity. With optimal treatment, the prognosis is good in terms of daily functions, quality of life and survival. Symptomatic treatment with acetylcholine esterase is usually combined with immunosuppression. A combination of prednisolone and azathioprine remains the first choice alternative, whereas rituximab is a promising second choice drug for severe generalized MG. Thymectomy is recommended for early-onset, generalized MG and for thymoma MG. In acute exacerbations including MG crisis, intravenous immunoglobulin and plasma exchange have good and similar effects. MG in young females needs therapeutic considerations regarding potential pregnancy. Introduction Myasthenia gravis (MG) is an autoimmune and a...
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