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Clinical comparison of anti-MuSK- vs anti-AChR-positive and seronegative myasthenia gravis

F. Deymeer, MD, MS (Epid), O. Gungor-Tuncer, MD, V. Ylmaz, MS, Y. Parman, MD, P. Serdaroglu, MD, C. Ozdemir, MD, A. Vincent, MBBS, MSc, FRCPath, FMedSci and G. Saruhan-Direskeneli, MD

From the Departments of Neurology (F.D., O.G.-T., Y.P., P.S., C.O.) and Physiology (V.Y., G.S.-D.), Istanbul University, Istanbul Medical Faculty, Istanbul, Turkey; and Neurosciences Group (A.V.), Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.

Address correspondence and reprint requests to Dr. Feza Deymeer, Department of Neurology, Istanbul University, Istanbul Medical Faculty, Capa, 34390 Istanbul, Turkey; e-mail: deymeer{at}tnn.net

We compared 65 anti-acetylcholine receptor (AChR)-negative myasthenia gravis (MG) patients, including 32 anti-muscle-specific tyrosine kinase (MuSK)-positive (49%) and 33 anti-MuSK-negative (seronegative) (51%) patients, with 161 anti-AChR-positive MG patients. The anti-MuSK-positive group had a higher frequency of bulbar involvement and respiratory crises. The seronegative group was in between the anti-MuSK positive and the anti-AChR positive groups, being closer to the latter, with regard to the severity of the disease. At the end of follow-up, the outcome of the anti-MuSK-positive patients was not different from that of the anti-AChR-positive patients, although their maintenance corticosteroid dose was higher. The seronegative patients had better outcome than the other two groups.

This work was supported by the Istanbul University Research Fund.

Disclosure: The authors report no conflicts of interest.

Received March 10, 2006. Accepted in final form November 1, 2006.

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