Autoantibody profile and clinical characteristics in a cohort of Chinese adult myasthenia gravis patients

• The frequencies of auto-antibodies vary in different MG subgroups.
• Thymoma and onset age were determining factors for the presence of autoantibodies.
• The presence of AChR, titin and RyR antibodies correlated with MG severity.
• A south-north distribution difference of MuSK antibody in East Asian MG patients.
• Titin and RyR antibodies are markers for more active immunosuppressive treatment.

Myasthenia gravis (MG) is an autoimmune disorder with heterogeneity. Antibodies against acetylcholine receptor (AChR), muscle-specific kinase (MuSK), titin and ryanodine receptor (RyR) were examined in 437 adult Chinese MG patients. The AChR, MuSK, titin and RyR antibodies were found in 82.2%, 2.3%, 28.4% and 23.8% of all patients. Autoantibody profiles vary among different MG subgroups. Thymoma MG patients had high frequencies of AChR (99.2%), titin (50.8%) and RyR antibodies (46.9%). The titin and RyR antibodies also showed high frequencies in late onset patients (54.4% and 33.3%, respectively). These two antibodies may indicate an underlying thymoma when combined. The patients with titin and RyR antibodies tend to have more severe disease and worse outcome, and may need more active immunosuppressive treatment.

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