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PLoS One. 2014 Dec 2;9(12):e114060. doi: 10.1371/journal.pone.0114060. eCollection 2014.

Repeated acetylcholine receptor antibody-concentrations and association to clinical myasthenia gravis development.

Author information

1
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
2
Centre of Clinical Research, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
3
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
4
Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Neurology, Haukeland University Hospital, Bergen, Norway.

Abstract

INTRODUCTION:

We aimed to examine the longitudinal association between Myasthenia Gravis (MG) clinical severity and concentration of acetylcholine receptor (AChR)-antibodies to evaluate if AChR-antibody variations correlate to disease severity. A positive AChR-antibody test is specific for MG.

MATERIAL AND METHODS:

All patients from western Norway who had two or more AChR- antibody tests in the period 1983-2013 were identified. The Myasthenia Gravis Foundation of America (MGFA) Clinical Classification was used to grade disease development. Multiple ordinal logistic regression analysis was used to estimate a possible predictive effect for AChR-antibody concentration on MGFA classification result.

RESULTS:

In 67 patients two or more AChR-antibody tests with a corresponding MGFA-score were performed, with a total of 309 tests. 56 patients were treated with immunosuppressive drugs and 11 by pyridostigmine only. There was a positive association between concentration of AChR-antibodies and longitudinal MGFA-score for the subgroup with immunosuppressive treatment, but not for those treated with pyridostigmine only. This association between AChR-antibody concentration and MGFA score declined with increasing time since onset (p = 0.005 for the interaction of group×time×concentration).

CONCLUSIONS:

For MG patients with immunosuppressive treatment, repeated AChR-antibody measurements give information about clinical development, and can therefore be of support in therapeutic decisions.

PMID:
25464006
PMCID:
PMC4252099
DOI:
10.1371/journal.pone.0114060
[Indexed for MEDLINE]
Free PMC Article

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