title: Fewer thymic changes in MuSK antibody-positive than in MuSK antibody-negative MG.
abstract: 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.
authors.affiliation: Neurosciences Group, Department of Clinical Neurology, University of Oxford, Oxford OX3 9DU, United Kingdom.
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Leite
authors.forename: Philipp
authors.initials: P
authors.lastname: Ströbel
authors.forename: Margaret
authors.initials: M
authors.lastname: Jones
authors.forename: Kingsley
authors.initials: K
authors.lastname: Micklem
authors.forename: Regina
authors.initials: R
authors.lastname: Moritz
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
authors.forename: Erik H
authors.initials: EH
authors.lastname: Niks
authors.forename: Sonia
authors.initials: S
authors.lastname: Berrih-Aknin
authors.forename: Francesco
authors.initials: F
authors.lastname: Scaravilli
authors.forename: Aurea
authors.initials: A
authors.lastname: Canelhas
authors.forename: Alexander
authors.initials: A
authors.lastname: Marx
authors.forename: John
authors.initials: J
authors.lastname: Newsom-Davis
authors.forename: Nick
authors.initials: N
authors.lastname: Willcox
authors.forename: Angela
authors.initials: A
authors.lastname: Vincent
mesh_terms: 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*
chemical_list: D000906:Antibodies; D018951:Antigens, CD20; D011950:Receptors, Cholinergic; D017463:Receptors, Complement 3b; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases