Heterogeneity of immunopathological features of AChR/MuSK autoantibody-negative myasthenia gravis.
We compared B cells and germinal centers in thymus from myasthenia gravis (MG) patients either with anti-acetylcholine receptor (AChR) autoantibodies or with neither anti-muscle-specific tyrosine kinase (MuSK) nor anti-AChR (seronegative MG: SN-MG). The numbers and frequencies of total and germinal center B cells varied in the SN-MG thymi, some of which were normal/atrophic. Others were clearly hyperplastic, their B cell parameters overlapping with those in AChR-positive MG, which implicates the thymus in pathogenesis. Indeed, some SN-MG patients apparently benefited from thymectomy, which should be considered a management option.
Hayashi
Akio
A
Department of Surgery, Osaka University Graduate School of Medicine, Japan.
Shiono
Hiroyuki
H
Ohta
Mitsuhiro
M
Ohta
Kiyoe
K
Okumura
Meinoshin
M
Sawa
Yoshiki
Y
D000293:Adolescent; D000328:Adult; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood*; D001402:B-Lymphocytes / Q000276:immunology; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D018858:Germinal Center / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000276:immunology* / Q000473:pathology*; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*; D013934:Thymectomy / Q000379:methods; D013950:Thymus Gland / Q000473:pathology*
D001323:Autoantibodies; D011950:Receptors, Cholinergic; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases