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NEUROLOGY 1988;38:138
© 1988 American Academy of Neurology

Neonatal myasthenia gravis

A new clinical and immunologic appraisal on 30 cases

E. Morel, PhD, B. Eymard, MD, B. Vernet-der Garabedian, PhD, C. Pannier, MD, O. Dulac, MD and J. F. Bach, PhD, MD

From INSERM U25—CNRS UA 122 (Drs. Morel, Vernet-der Garabedian, and Bach), Hopital Necker; Service de Neurologie (Pr. P. Brunet) (Dr. Eymard), Hopital de la Salpétrière; CNRS UA 1159 (Dr. Pannier), Centre Chirurgical Marie Lannelongue; and INSERM U29 and Service de Neuropédiatrie (Pr. Arthuis) (Dr. Dulac), Hopital Saint Vincent de Paul, Paris, France.

Anti-acetylcholine receptor (AChR) antibody titers, toxin binding blocking antibody, functional activity of serum on rat myotube cultures, IgG subclasses, and clinical data were studied in relation to the onset of neonatal myasthenia gravis (NMG) in 30 children of myasthenic mothers. Fourteen had NMG, including 4 atypical cases. Anti-AChR antibody titer was the best indication of NMG onset. NMG in a previous baby was also predictive. Pattern of IgG subclasses, presence of toxin-binding blocking antibodies, and serum functional activity were less predictive, but cast light on the mechanism of anti-AChR antibody pathogenicity.

Address correspondence and reprint requests to Dr. Morel, Immunologie Clinique, Hôpital Necker, 161, Rue de Sevres, 75743 Paris CEDEX 15, France.

Supported in part by a grant from the Association des Myopathes de France. B. Vernet-der Garabedian was a fellow of Fondation pour la Recherche Medicate.

Received September 30, 1986. Accepted for publication in final form March 11, 1987.




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