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June 11, 1982

Antiacetylcholine Receptor Antibodies and Myasthenia Gravis

JAMA. 1982;247(22):3082. doi:10.1001/jama.1982.03320470030022

To the Editor.—  The article "Ocular Myasthenia: Multiple Recurrences and Spontaneous Remissions" (1982; 247:62), by M. Seth Hochman, MD, was intellectually stimulating. Other neurologists1 doubt the role of antiacetylcholine receptor (anti-AChR) antibodies in the pathogenesis of myasthenia gravis (MG). I find this particularly convincing to me because young myasthenics benefit from thymectomy whether or not they have detectable antibodies. Interestingly, even without antibodies and with the thymus gland removed, it is my experience that exacerbations can still be provoked by minor respiratory tract infections.I would appreciate it if Dr Hochman could comment on multiple recurrences and spontaneous remissions without alluding to AChR anti-bodies. bodies. Second, I would like to ask if the long-lived memory T cells may explain some of the residual exacerbations occurring in thymectomized patients.