Autoantibody detection by a live cell-based assay in conventionally antibody-tested triple seronegative Myasthenia gravis
Sarah Hoffmann, Patrick Waters, Leslie Jacobson, Markus Schuelke, Werner Stenzel, Tobias Ruck, Sophie Lehnerer, Frauke Stascheit, Corinna Preuße, Andreas Meisel
Abstract
Autoantibody testing is the mainstay in confirming the diagnosis of autoimmune myasthenia gravis (MG). However, in approximately 15% of patients, antibody testing in clinical routine remains negative (seronegative MG). This study aimed at assessing the prevalence of "clustered" AChR- and MuSK- and LRP4- autoantibodies using a live cell-based assay in a large German cohort of seronegative myasthenia gravis (SNMG) patients. A total of 67 SNMG patients were included. Clustered AChR-ab were identified in 4.5% (n = 3) of patients. Two out of the three patients showed binding to the adult AchR as well as the fetal AchR. None of the patients was positive for MuSK- or LRP4-autoantibodies. There were no differences in clinical characteristics between the patients with and without clustered AChR-ab detection. Comparison of clinical data of our cohort with clinical data from the nationwide Myasthenia gravis registry showed broad similarities between seronegative MG patients of both cohorts.