Fewer thymic changes in MuSK antibody-positive than in MuSK antibody-negative MG.
In generalized myasthenia gravis (MG) patients without detectable acetylcholine receptor (AChR) antibodies (SNMG), the thymus is often reported as "normally involuted." We analyzed thymic compartments in 67 patients with generalized MG, with AChR antibodies (AChR+, n = 23), with muscle-specific kinase (MuSK) antibodies (MuSK+, n = 14) or with neither (MuSK-, n = 30), and in 11 non-MG controls. Four of 14 MuSK+ thymi had rare small germinal centers, but overall they were not different from age-matched controls. However, approximately 75% MuSK- samples showed lymph node-type infiltrates similar to those in AChR+ patients, but with fewer germinal centers. These variations may explain some apparent differences in responses to thymectomy in SNMG.
Leite
Maria Isabel
MI
Neurosciences Group, Department of Clinical Neurology, University of Oxford, Oxford OX3 9DU, United Kingdom.
Ströbel
Philipp
P
Jones
Margaret
M
Micklem
Kingsley
K
Moritz
Regina
R
Gold
Ralf
R
Niks
Erik H
EH
Berrih-Aknin
Sonia
S
Scaravilli
Francesco
F
Canelhas
Aurea
A
Marx
Alexander
A
Newsom-Davis
John
J
Willcox
Nick
N
Vincent
Angela
A
D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000378:metabolism*; D018951:Antigens, CD20 / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000276:immunology* / Q000473:pathology; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*; D017463:Receptors, Complement 3b / Q000378:metabolism; D013950:Thymus Gland / Q000378:metabolism / Q000473:pathology*
D000906:Antibodies; D018951:Antigens, CD20; D011950:Receptors, Cholinergic; D017463:Receptors, Complement 3b; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases