title: Anti-MuSK Antibody-positive Myasthenia Gravis Mimicking Amyotrophic Lateral Sclerosis.
abstract: We herein investigated the clinical features of three patients with anti-muscle-specific tyrosine kinase (MuSK) antibody-positive myasthenia gravis (MG), which was initially difficult to distinguish from amyotrophic lateral sclerosis (ALS). The patients exhibited dropped head syndrome or dysphagia as initial symptoms. Although their clinical findings were compatible with the revised El Escorial Criteria for ALS, their progression appeared to be more rapid than that of ALS. Both the edrophonium and repetitive nerve stimulation tests yielded negative results, and diurnal fluctuation was not confirmed. The patients were ultimately diagnosed with anti-MuSK antibody-positive MG. We therefore recommend the measurement of anti-MuSK antibodies when encountering such cases.
authors.affiliation: Department of Neurology, Gunma University Graduate School of Medicine, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Furuta
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Ishizawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Shibata
authors.forename: Setsuki
authors.initials: S
authors.lastname: Tsukagoshi
authors.forename: Shun
authors.initials: S
authors.lastname: Nagamine
authors.forename: Kouki
authors.initials: K
authors.lastname: Makioka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Fujita
authors.forename: Masaki
authors.initials: M
authors.lastname: Ikeda
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yoshimura
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Motomura
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000097:blood / Q000175:diagnosis*; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003680:Deglutition Disorders / Q000209:etiology*; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood / Q000175:diagnosis*; D011239:Prednisolone / Q000008:administration & dosage; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*; D016896:Treatment Outcome; D014443:Tyrosine
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D005938:Glucocorticoids; D011950:Receptors, Cholinergic; D014443:Tyrosine; D011239:Prednisolone; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases