title: Anti-LRP4 autoantibodies in Chinese patients with myasthenia gravis.
abstract: BACKGROUND
  We assessed antibodies against low-density lipoprotein receptor-related protein 4 (LRP4-Ab) in a Chinese population with myasthenia gravis (MG).
  
  
  METHODS
  Serum samples from 116 patients and 80 controls were collected. Acetylcholine receptor antibodies(AChR-Ab) and muscle-specific receptor tyrosine kinase antibodies (MuSK-Ab) were tested using an enzyme-linked immune absorption assay, and LRP4-Ab was identified using a cell-based assay. MG patients with neither AChR-Ab nor MuSK-Ab were defined as double-seronegative MG (dSN-MG).
  
  
  RESULTS
  Two of 116 (1.7%) of all patients and 2 of 50 (1%) dSN-MG patients were positive for LRP4-Ab. These 2 patients had ocular MG. Following treatment with acetylcholinesterase inhibitor and prednisone, both achieved full remission.
  
  
  CONCLUSIONS
  This study shows that LRP4-Ab is a pathogenic antibody in MG. LRP4-MG seems to be characterized by mild disease severity and favorable therapeutic effect in contrast with other types of MG. Muscle Nerve 56: 938-942, 2017.
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Cai
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Dian
authors.initials: D
authors.lastname: He
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Qingqing
authors.initials: Q
authors.lastname: Dai
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Gui Yi Street, Guiyang, Guizhou Province, 550004, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Chu
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D044466:Asian People; D001323:Autoantibodies / Q000097:blood*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D026502:LDL-Receptor Related Proteins / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000097:blood* / Q000188:drug therapy / Q000276:immunology*; D011241:Prednisone / Q000627:therapeutic use; D020794:Receptor Protein-Tyrosine Kinases / Q000276:immunology; D011950:Receptors, Cholinergic / Q000276:immunology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D002800:Cholinesterase Inhibitors; D026502:LDL-Receptor Related Proteins; C551781:LRP4 protein, human; D011950:Receptors, Cholinergic; C095714:MUSK protein, human; D020794:Receptor Protein-Tyrosine Kinases; D011241:Prednisone
keywords: acetylcholine receptor autoantibodies; clinic presentation; low-density lipoprotein receptor-related protein 4 autoantibodies; muscle-specific tyrosine kinase receptor autoantibodies; myasthenia gravis; pathogenic mechanism