The high frequency and clinical feature of seronegative myasthenia gravis in Southern China

被引:20
作者
Feng, Hui-yu [1 ]
Wang, Hai-yan [1 ]
Liu, Wei-bin [1 ]
He, Xue-tao [2 ]
Huang, Xin [1 ]
Luo, Chuan-ming [1 ]
Li, Yan [1 ]
机构
[1] Sun Yat Sen Univ, Dept Neurol, Affiliated Hosp 1, Guangzhou 510080, Guangdong, Peoples R China
[2] Guangdong Gen Hosp, Dept Neurol, Guangzhou 510080, Guangdong, Peoples R China
基金
中国国家自然科学基金;
关键词
Myasthenia gravis; Anti-acetylcholine receptor antibodies; Anti-muscle-specific tyrosine kinase antibodies; Clinical features; Seropositive MG; Seronegative MG; TYROSINE KINASE MUSK; RECEPTOR ANTIBODY; DISEASE; AUTOANTIBODIES; TITERS; MG;
D O I
10.1007/s10072-012-1159-x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Anti-acetylcholine receptor antibodies (anti-AChR-Ab) are responsible for the failure of neuromuscular junction in myasthenia gravis (MG). Some anti-AChR-Ab-seronegative MG patients have anti-muscle-specific tyrosine kinase antibodies (anti-MuSk-Ab). Here, the anti-AChR-Ab was tested in 250 MG outpatients from Southern China. While anti-MuSk-Ab was tested in 66 patients who had no anti-AChR-Ab in blood serum, but none of them was positive. The antibodies were measured by a radioimmunoprecipitation assay. The frequency of anti-AChR-Ab was 51.2 %. The percentage of anti-AChR-Ab in ocular type was lower than generalized type (44.9 vs. 66.2 %, P = 0.002). Seronegative MG was characterized by a lower percentage of thymoma than seropositive patients (P = 0.013). It seemed to be less severe in seronegative MG than seropositive MG in these 250 patients. In ocular type, seronegative MG mainly manifesting blepharoptosis but seldom diplopia or eyeball fixation related to ocular movement disability (P = 0.016). While in generalized type, seronegative MG was characterized by a lower percentage of bulbar muscle involvements than seropositive patients (P = 0.005). Logistic regression analysis revealed that bulbar weakness was affected by the existence of anti-AChR antibodies (OR = 3.524, P = 0.015). Besides, seronegative MG tended to be characterized by a lower percentage of neck extensor involvement, but this did not reach significance. The percentage of anti-AChR antibodies was much lower than other countries. Seronegative MG has characteristic clinical features that are different from features of the remaining seropositive MG. This emphasises the predictive value of anti-AChR antibodies analysis in MG patients.
引用
收藏
页码:919 / 924
页数:6
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