Anti-AChR, MuSK, and LRP4 antibodies coexistence: A rare and distinct subtype of myasthenia gravis from Indian subcontinent.

Abstract

BACKGROUND:

Myasthenia gravis is B-cell mediated autoimmune disease and is associated with antibodies against the acetylcholine receptor (AChR), muscle-specific kinase (MuSK) and lipoprotein-related protein 4 (LRP4) in the postsynaptic membrane at the neuromuscular junction. There are few studies on the concurrent presence of two positive antibodies in the sera of patients with myasthenia gravis.

CASE DESCRIPTION:

A 32-year male admitted to the hospital with progressive neuromuscular weakness. He was diagnosed with Myasthenia gravis disorder mimicking Amyotrophic Lateral Sclerosis. We herein report a rare co-existence of three antibodies (anti-AChR, MuSK, and LRP4 antibodies) in the patient's serum.

CONCLUSION:

We present a detailed clinical and laboratory analysis of the patient. This case report will emphasize the importance of evaluating anti-MuSK and anti-LRP4 antibodies even in patients with anti-AChR antibodies.

• Authors: Suresh C Bokoliya, Veeramani Preethish Kumar, Saraswati Nashi, Kiran Polavarapu, Atchayaram Nalini, Shripad A Patil
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 486 Pg. 34-35 (Nov 2018) ISSN: 1873-3492 [Electronic] Netherlands
• PMID: 30006288 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2018. Published by Elsevier B.V.

Chemical References

• LDL-Receptor Related Proteins
• LRP4 protein, human
• Receptors, Cholinergic
• MUSK protein, human
• Receptor Protein-Tyrosine Kinases

Topics

• Adult
• Humans
• India
• LDL-Receptor Related Proteins (blood)
• Male
• Myasthenia Gravis (blood, diagnosis)
• Receptor Protein-Tyrosine Kinases (blood, metabolism)
• Receptors, Cholinergic (blood, metabolism)