The titer of MuSK autoantibodies is reflective of the clinical improvement observed after B-cell depletion therapy. However, the titer of AChR-specific autoantibodies correlates unsuccessfully with clinical progress.
Regardless of the presence or absence of thymic abnormalities, thymectomy has yet been shown to improve clinical outcomes for patients with MuSK MG; therefore, thymectomy represents a therapy option for patients with AChR MG.
Patients with MuSK MG respond positively to treatment with rituximab, whereas patients with AChR MG have not shown the same reaction. This divergence in treatment efficacy may be due to differences in the tissue localization of B-cell subsets of MG. It may also be due to the susceptibility of different autoantibody-producing B-cell subsets to anti-CD20 depletion (ie, plasmablasts in MuSK MG vs plasma cells in AChR MG, each expressing different levels of CD20).
Learn more about the pathophysiology of MG.
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Cite this: Raghav Govindarajan. Fast Five Quiz: Pathophysiology of Myasthenia Gravis - Medscape - Oct 08, 2021.