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Seronegative Myasthenia Gravis

Myasthenia gravis without acetylcholine receptor antibodies.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Nöroloji department. Book Appointment →

What is Seronegative Myasthenia Gravis?

Approximately 10-15% of myasthenia gravis patients are negative for acetylcholine receptor (AChR) antibodies. In this group, 40-70% have anti-MuSK and 1-3% have anti-LRP4 antibodies; the remainder are 'truly seronegative.'

Anti-MuSK MG more often involves the bulbar, facial, neck, and respiratory muscles, with frequent crises. Patients are usually women aged 20-40 with weight loss, dysarthria, and dysphagia.

Diagnosis is supported by repetitive nerve stimulation, single-fiber EMG, and clinical response to neostigmine. Treatment differs from classic MG: pyridostigmine is less effective, plasmapheresis and rituximab are first-line; thymectomy is generally not beneficial.

Symptoms

Bulbar weakness (dysarthria, dysphagia)
Marked facial weakness
Tongue and masseter atrophy
Neck flexor weakness
Respiratory muscle weakness
Ptosis and diplopia (less than classic MG)
Frequent myasthenic crisis

Risk Factors

Female sex
Age 20-40
Anti-MuSK antibody positivity
HLA-DR14, HLA-DQ5
Autoimmune disease comorbidity
Family history
Mediterranean origin

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden dysphagia
  • Dysarthria
  • Facial weakness
  • Shortness of breath
  • Worsening of weakness with exertion

Treatment Methods

01
Anti-MuSK and anti-LRP4 antibody testing
02
Repetitive nerve stimulation/single-fiber EMG
03
Pyridostigmine (less effective)
04
Prednisolone (high dose)
05
Plasmapheresis or IVIG (in crisis)
06
Rituximab (refractory cases)
07
Respiratory and nutritional support

Which Department to Visit?

You can visit our Nöroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.