To the Editor.—
Antibodies of acetylcholine receptors (AchRs), present in most cases of myasthenia gravis (MG), play an etiologic role in this disease.1 Although they accelerate the degradation of AchRs,2 their titer level does not predict the magnitude of generalized symptoms.1Antibodies to AchRs cross the placental barrier and their presence has been documented in infants with transient neonatal MG.3-5 We recently documented high AchR-antibody titers in two myasthenic mothers (one with moderate generalized weakness who received prednisone, and the other with only mild facial weakness who received no medication) and their three asymptomatic infants (Table). Despite the high titers of antibodies to AchRs, all infants (including one with respiratory distress due to hyaline membrane disease and pneumonia that was treated with ampicillin sodium and gentamycin sulfate) showed no weakness or decremental responses on two per second nerve stimulation during the neonatal period. A few asymptomatic
Gutmann L, Seybold ME. Acetylcholine Receptor Antibodies in Absence of Neonatal Myasthenia Gravis. Arch Neurol. 1980;37(11):738. doi:10.1001/archneur.1980.00500600086026
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