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From the Departments of Neurology and Surgery, Columbia-Presbyterian Medical Center, College of Physicians and Surgeons of Columbia University, New York, NY.
Of 221 patients with myasthenia gravis, 18. 5% had no detectable antibodies to acetylcholine receptor. Seven of 14 patients (50%) with only ocular symptoms for more than 2 years were seronegative, and 25 of 145 (17%) patients with generalized myasthenia were seronegative. The clinical characteristics of seronegative patients did not differ from patients with high antibody titers. No seronegative patient had a thymoma, but that difference did not reach statistical significance. Lack of serum antibodies did not preclude favorable response to thymectomy or plasmapheresis.
Address correspondence and reprint requests to Dr. Lange, The Neurological Institute, 710 West 168th Street, New York, NY 10032.
Supported by Center Grants from NINCDS (NS-11766), the Muscular Dystrophy Association, and the General Clinical Research Center (RR00645).
Received April 20, 1987. Accepted for publication in final form August 12, 1987.
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