• It has recently been demonstrated that pathogenic immunoglobulins circulate in the blood of patients with acetylcholine-receptor-antibody (A-AChR)-negative myasthenia gravis (MG). Evidence has been presented that in this form of MG the neuromuscular transmission is impaired by antibodies that bind to end-plate determinants other than the AChR. We describe three patients with clinical manifestations of A-AChR—negative MG in whom antibody directed to reticulin (A-Ret) was detected. Antibody directed to reticulin is usually associated with celiac disease; however, none of the patients had symptoms or signs of celiac disease. To our knowledge, the association of A-Ret with A-AChR—negative MG has not been reported before. We postulate that A-Ret might help to differentiate between A-AChR-negative MG and congenital myasthenia. Further studies are needed to determine whether A-Ret plays a pathogenic role in A-AChR-negative MG or should instead be considered as an epiphenomenon.
Hoogenraad TU, Meyling FHJG. Putative Role of Antireticulin Antibody in Antiacetylcholine-Receptor-Antibody-Negative Myasthenia Gravis. Arch Neurol. 1987;44(5):536–538. doi:10.1001/archneur.1987.00520170062023
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