title: Seropositive myasthenia and autoimmune autonomic ganglionopathy: cross reactivity or subclinical disease?
abstract: Autoimmune autonomic ganglionopathy (AAG) and myasthenia gravis (MG) are both autoimmune channelopathies mediated by antibodies directed against nicotinic acetylcholine receptors. While both diseases target acetylcholine receptors, skeletal muscle and ganglionic receptor subtypes have key immunologic and genetic distinctions, and reports of patients with both AAG and MG are rare. We report a patient with antibody-confirmed AAG and elevated levels of ACh binding antibodies that did not meet clinical or electrodiagnostic criteria for MG. We presume that his skeletal muscle nAChR seropositivity was a false positive, perhaps due to the cross reactivity of the patient's ganglionic nAChR antibodies with skeletal nAChR subtypes.
authors: Dysautonomia Center, Department of Neurology, New York University School of Medicine, 530 First Avenue Suite 9Q, New York, NY, 10016, USA. Mitchell.Miglis@nyumc.org
authors: Mitchell G
authors: MG
authors: Miglis
authors: Rikki
authors: R
authors: Racela
authors: Horacio
authors: H
authors: Kaufmann
mesh_terms: D000369:Aged, 80 and over; D001323:Autoantibodies / Q000096:biosynthesis* / Q000097:blood; D020274:Autoimmune Diseases of the Nervous System / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D001342:Autonomic Nervous System Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D003429:Cross Reactions / Q000276:immunology; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005725:Ganglia, Autonomic / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D009157:Myasthenia Gravis / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D011978:Receptors, Nicotinic / Q000145:classification / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D011978:Receptors, Nicotinic