Abstract :
Eighty percent of patients with myasthenia gravis have acetyl choline receptor antibody (AChRAb) and 6% have antibody to muscle specific tyrosine kinase (MuSK). MuSK myasthenia is characterised by prominent bulbar muscle involvement, rapid progression to myasthenic crisis, poor response to acetylcholinesterase inhibitors (ACEI), intravenous immunoglobulin, standard immunosuppressant therapies and thymectomy. Presence of both AChRAb and MuSK antibody in same patient is a rare occurrence-Double Sero Positive Myasthenia Gravis (DSP-MG). DSP-MG has a variable prognosis as some patients behave like AChRAb MG while rest behave like MuSK MG. Here we describe a patient with DSP-MG who presented with generalized myasthenia gravis who responded to ACEI.
Keyword :
Double seropositive myasthenia gravis, Acetyl choline receptor antibody, Anti MuSK antibody