The association between anti-acetylcholine receptor antibody level and clinical improvement in myasthenia gravis.

Abstract

BACKGROUND AND PURPOSE:

Anti-acetylcholine receptor (AChR) antibodies (ab) in the serum are detected in most patients with generalized myasthenia gravis (MG) and used as a diagnostic tool. The aim of this study was to analyse a possible association between anti-AChR-ab serum levels and clinical improvement of MG.

METHODS:

The Maastricht University Medical Center is a centre of expertise for the treatment of MG. Between 1997 and 2020, more than 4000 anti-AChR-ab blood samples were measured for clinical care using a quantitative radioimmunoassay technique. These results, in combination with clinical status obtained from the patients' electronic patient files, were retrospectively analysed by a single blinded clinician. Symptoms of MG were classified using the Myasthenia Gravis Foundation of America (MGFA) scale.

RESULTS:

In total, 90 anti-AChR-ab-positive MG patients with 837 blood samples were included. The median follow-up time was 72 months. The majority of the included patients were women (61.1%), were on immunosuppressive drug therapy (88.9%), and underwent a thymectomy (54.4%). Multilevel logistic regression analysis showed a significantly inverse association between change in anti-AChR-ab level and the odds of MGFA improvement (per 10% decrease of anti-AChR-ab level: odds ratio 1.21, 95% confidence interval 1.12-1.31; p < 0.001).

CONCLUSIONS:

A change in anti-AChR-ab serum level is associated with clinical status in patients with MG. Analyses of anti-AChR-ab are not only useful for diagnostics but also in follow-up of adult symptomatic patients with MG. The use of repetitive anti-AChR-ab serum levels might be valuable in long-term monitoring for clinical improvement in patients with MG, however, further research is required for specific recommendations.

• Authors: Florit Marcuse, Lloyd Brandts, Daan Moens, Jan Damoiseaux, Monique Hochstenbag, Janneke G J Hoeijmakers, Jos G Maessen, Marc De Baets
• Journal: European journal of neurology (Eur J Neurol) Vol. 29 Issue 4 Pg. 1187-1197 (04 2022) ISSN: 1468-1331 [Electronic] England
• PMID: 34967067 (Publication Type: Journal Article)
• Copyright: © 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Chemical References

• Autoantibodies
• Receptors, Cholinergic

Topics

• Adult
• Autoantibodies
• Female
• Humans
• Male
• Myasthenia Gravis
• Receptors, Cholinergic
• Retrospective Studies
• Thymectomy