Laboratory Investigation of Hybrid IgG4 k/λ in MuSK Positive Myasthenia Gravis

Basile, Umberto; Napodano, Cecilia; Gulli, Francesca; Pocino, Krizia; Santo, Riccardo Di; Todi, Laura; Basile, Valerio; Provenzano, Carlo; Ciasca, Gabriele; Marino, Mariapaola

doi:10.3390/ijms22179142

Cited by 4 publications

(2 citation statements)

References 30 publications

(52 reference statements)

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“…Anti-MuSK antibodies are identified in 5–8% of MG cases 12 . The reference values for MuSK antibodies are typically ≤0.02 nmol/l 7 . In our patient the MUSK-antibody in our patient was tested positive with an elevated value of 18.6.…”

Section: Discussionmentioning

confidence: 99%

An unusual initiation of an ocular form of MuSK-positive myasthenia gravis after magnesium administration: a rare case report

Almohamed,

Karaja,

Qatza

et al. 2024

Annals of Medicine &Amp; Surgery

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Introduction and importance: The primary clinical symptom in people with myasthenia gravis is muscle weakness that gets worse with activity and gets better with rest; often, the first symptoms are ocular ones, such as ptosis and double vision. On the other hand, individuals with anti-MuSK may present with unusual symptoms. Nonetheless, it is hypothesized that musk antibodies may be present when there are no antibodies present along with bulbar and respiratory symptoms. Case Presentation: A 26-year-old pregnant patient was referred to the neurology department after experiencing tongue enlargement. A neuro ophthalmic assessment revealed ptosis with lateral diplopia in the right eye, bulbar palsy, facial weakness, weakness in the palate and pharyngeal reflex, dizziness, and hearing loss in her right ear. The patient was given magnesium sulfate for two days since pre-eclampsia was suspected; however, this treatment exacerbated the development of symptoms and was discontinued. Her myasthenia gravis symptoms gradually improved after starting medication nonetheless, bilateral weakness in the neck and limb flexion persisted. Following a few days of therapy, there were no indications of diplopia, swallowing was normal, and the muscular weakness was somewhat improved. Clinical discussion: The pasiont put on drug treatment for myasthenia gravis (predlon 60 mg daily, amioran 50 mg twice daily and mistenon) Conclusion: Treating severe myasthenia gravis patients with a customized approach aims to manage their symptoms and improve their quality of life. Reduce muscle weakness, eradicate circulating antibodies, and suppress the abnormal immunological response. Minimizing side effects while attaining ideal symptom control is the ultimate objective.

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Section: Discussionmentioning

confidence: 99%

An unusual initiation of an ocular form of MuSK-positive myasthenia gravis after magnesium administration: a rare case report

Almohamed,

Karaja,

Qatza

et al. 2024

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“…The fourth original article is that of Basile and colleagues who investigated the diagnostic-prognostic biomarker potential of hybrid IgG4 k/λ antibodies in patients with a specific disease subtype of Myasthenia gravis [4]. The disease subtypes are classified according to the production of antibodies against the muscle-specific tyrosine kinase (MuSK) or the acetylcholine receptor (AChR), with the former having a proven IgG4-mediated pathogenicity.…”

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confidence: 99%