Anti-Titin Antibodies in Myasthenia Gravis

作者：Ana‐Maria Yamamoto, Philippe Gajdos, B. Eymard, Christine Tranchant, Jean-Marie Warter, Lucienne Gomez, Charles Bourquin, Jean‐François Bach, Henri‐Jean Garchon · 发表于：Archives of Neurology · 年份：2001 · DOI：10.1001/archneur.58.6.885 · 被引用次数：146 · 研究领域：Myasthenia Gravis and Thymoma、Autoimmune Neurological Disorders and Treatments、Peripheral Neuropathies and Disorders

BACKGROUND: Titin is the major autoantigen recognized by anti-striated muscle antibodies, which are characteristic of generalized myasthenia gravis (MG). OBJECTIVE: To seek a correlation between anti-titin antibodies and other features of MG patients, including histopathology, age at diagnosis, anti-acetylcholine receptor (anti-AChR), autoantibody titers, and clinical severity. METHODS: A novel, highly specific radioligand assay was performed on a large group of 398 patients with generalized MG. RESULTS: Among thymectomized patients, anti-titin antibodies were present in most patients with thymoma (56/70 [80%]), contrasting with only a minority of patients with thymus atrophy or hyperplasia (17/165 [10%]). They were also present in 64 (41%) of 155 nonthymectomized patients who had a radiologically normal thymus. In these patients and in those who had a histologically normal thymus, anti-titin antibodies were associated with a later age at onset of disease and with intermediate titers of anti-AChR antibodies. After controlling for these 2 variables, disease severity was not significantly influenced by anti-titin antibodies. CONCLUSIONS: Anti-titin antibodies are a sensitive marker of thymoma associated with MG in patients 60 years and younger, justifying the insistent search for a thymoma in MG patients of this age group who have these antibodies. In nonthymoma patients, anti-titin antibodies represent an interesting marker complementary to the anti-AChR antibody titer, identi...