Analysis Of Clinical Characteristics Of Myasthenia Gravis Patients Based On Serum Antibody Typing

Background and Objective:Myasthenia gravis(MG)is an acquired autoimmune disease targeting the postsynaptic acetylcholine receptors of the neuromuscular junction(NMJ).The known causative antibodies are acetylcholine receptor antibody(AChR-Ab),muscle specific tyrosine kinase antibody(MuSK-Ab),and low-density lipoprotein receptor-related protein 4(LRP4-Ab).In addition,some patients have serum Titin-Ab and RyR-Ab,which are currently considered as markers of thymoma and correlated with the severity of the diease.The pathogenesis of MG is complex and the clinical manifestations of patients are diverse.The classification of patients based on the types of serum antibodies and the analysis of the clinical characteristics of each subgroup of patients will be of guiding significance for the individualized treatment of MG patients.Methods:Retrospective analysis of MG patients hospitalized in the Department of Neurology,China-Japan Union Hospital of Jilin University from January 2019 to July2022.According to serum antibody types,the patients were divided into AChR-MG,MuSK-MG and DSN-MG groups,as well as AChR-Ab(+)group and AChR+Titin-MG group,and the clinical characteristics of each group were compared.Results:A total of 52 patients were included,41(78.8%)patients in the AChR-MG group,3(5.8%)patients in the MuSK-MG group,and 8(15.4%)patients in the DSN-MG group.There were 27 patients in AChR-Ab(+)group and 14 patients in AChR+TitinMG group.There was a statistical difference in MGFA typing between AChR-MG,MuSK-MG and DSN-MG groups(P < 0.05).Compared to AChR(+)group,patients with AChR+Titin-MG had a higher proportion of LOMG(100% VS 66.7%,P<0.05),a higher rate of positive RNS(85.7% VS 44.4%,P<0.05),a greater tendency to involve the bulbar muscles(64.3% VS 18.5%,P<0.01)and thymoma(57.1% VS18.5%,P<0.05)had higher odds of.Conclusions:1.There were statistical differences in MGFA typing among AChR-MG,MuSKMG and DSN-MG groups.2.MuSK-MG group all involved bulbar muscles without thymoma.3.The proportion of LOMG patients in AChR+Titin-MG group was higher than that in AChR-Ab(+)group.4.The incidence of thymoma was higher in the AChR+Titin-MG group,and it was more likely to involve the bulbar muscle than in the AChR-Ab(+)group.