title: Overcoming challenges in the diagnosis and treatment of myasthenia gravis.
abstract: In recent years, the discovery of new autoantigens and the use of sensitive assays have expanded the clinical spectrum of myasthenia gravis (MG). In particular, antibodies binding to clustered acetylcholine receptors and to the low-density lipoprotein receptor-related protein 4 have not only bridged a significant gap in diagnosis but also have relevant clinical implications. MG management includes different therapeutic options, from symptomatic agents as the only therapy in mildly affected cases to combined long-term immunosuppression and thymectomy in patients with severe disabling disease. MG biological diversity can influence the response to therapies and should be taken into account when planning treatment. Biologic agents are promising, though their use is currently limited to patients with refractory disease.
authors.affiliation: a Institute of Neurology , Catholic University , Roma , Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Evoli
authors.affiliation: a Institute of Neurology , Catholic University , Roma , Italy.|b Don Gnocchi ONLUS Foundation , Milan , Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Iorio
authors.affiliation: c Institute of General Pathology , Catholic University , Roma , Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Bartoccioni
mesh_terms: D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007167:Immunotherapy / Q000379:methods; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology; D013934:Thymectomy / Q000379:methods
chemical_list: D001323:Autoantibodies; D002800:Cholinesterase Inhibitors; D007074:Immunoglobulin G; D011950:Receptors, Cholinergic; D020794:Receptor Protein-Tyrosine Kinases; D011729:Pyridostigmine Bromide
keywords: AChR; Lrp4; MuSK; clustered-AChR; immunosuppressants; myasthenia gravis; thymectomy