title: AChR-myasthenia gravis switching to double-seropositive several years after the onset.
abstract: We report an early onset AChR-myasthenia gravis (MG) with biphasic clinical course. The clinical "switch" from AChR-MG to MuSK-MG emerged 16 years after the onset and 11 years after thymectomy. MuSK antibodies were detected only by cell-based assay and only upon clinical "switch", while AChR antibodies remained positive and at high titers during the whole disease course. Although the occurrence of AChR antibodies and MuSK antibodies in the same individual is rare, the re-assessment of the antibody status, using all available assays, is advisable when there is clinical indication.
authors.affiliation: Neurology Department, Aeginition Hospital, University of Athens, Greece. Electronic address: vzouvelu@med.uoa.gr.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Zouvelou
authors.affiliation: Department of Biochemistry, Hellenic Pasteur Institute, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Zisimopoulou
authors.affiliation: Renal Unit, Alexandra Hospital, Athens, Greece.
authors.forename: Erasmia
authors.initials: E
authors.lastname: Psimenou
authors.affiliation: Department of Biochemistry, Hellenic Pasteur Institute, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Matsigkou
authors.affiliation: Neurology Department, Aeginition Hospital, University of Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Stamboulis
authors.affiliation: Department of Biochemistry, Hellenic Pasteur Institute, Greece; Tzartos NeuroDiagnostics, Athens, Greece.
authors.forename: Socrates J
authors.initials: SJ
authors.lastname: Tzartos
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009157:Myasthenia Gravis / Q000276:immunology* / Q000378:metabolism*; D011950:Receptors, Cholinergic / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic
keywords: Acetylcholine receptor; Biphasic course; Cell-based assay; Double seropositive; Muscle-specific kinase; Myasthenia gravis