New clinical entity of myasthenia gravis with autoimmune targets of heart and skeletal muscles

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Since previous case reports have shown inflammatory myopathies in a few patients with myasthenia gravis (MG), heart and skeletal muscles are speculated to be autoimmune targets in MG. We screened to investigate the clinical, histological and immunological features of MG patients, who also developed myocarditis and/or myositis at 5 Japanese hospitals. Of 924 MG patients, eight (0.9%) had inflammatory myopathies. The onset age of MG was 55.3 ± 10.3 years. All patients showed severe symptoms with bulbar involvement accompanied by myasthenic crisis in 5 and invasive thymoma in 4. Myocarditis was found in 3 patients and myositis in 6. Myocarditis, developing 13-211 months after the MG onset, was characterized by heart failure and arrhythmias. Myositis, developing before or at the same time as MG, affected limb and paraspinal muscles. Histological findings of skeletal muscles showed CD8 + lymphocyte infiltration. Seven patients had one of these anti-striational autoantibodies (those to titin, ryanodine receptor, muscular voltage-gated potassium channel, Kv l.4). Immunomodulatory therapy was required in all patients and was effective for both MG and inflammatory myopathies, except for one autopsy case. Heart and skeletal muscles are autoimmune targets in some MG patients. This autoimmunity has a broad clinical spectrum with anti-striational autoantibodies.

Original languageEnglish
Pages (from-to)1312-1314
Number of pages3
JournalClinical Neurology
Volume52
Issue number11
DOIs
Publication statusPublished - 2012

Fingerprint

Myasthenia Gravis
Myocardium
Skeletal Muscle
Myositis
Myocarditis
Autoantibodies
Connectin
Paraspinal Muscles
Voltage-Gated Potassium Channels
Ryanodine Receptor Calcium Release Channel
Thymoma
Immunomodulation
Muscle Weakness
Autoimmunity
Age of Onset
Cardiac Arrhythmias
Autopsy
Extremities
Heart Failure
Lymphocytes

Keywords

  • Anti-striational autoantibodies
  • Myasthenia gravis
  • Myocarditis
  • Myositis

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

New clinical entity of myasthenia gravis with autoimmune targets of heart and skeletal muscles. / Suzuki, Shigeaki.

In: Clinical Neurology, Vol. 52, No. 11, 2012, p. 1312-1314.

Research output: Contribution to journalArticle

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