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Myasthenia Gravis

Testing

11/03/2008

Question:

My dad is having surgery to remove a growth and they took an ACH receptor modulating AB test. They said that it was very important and that they needed the test back before the surgery or the surgery would have to be postponed, but they did not tell us why they took it or why it is so important.

Could you tell me what the test is for and why it is so important to have before the surgery?

Answer:

There are several antibodies that we check in making the diagnosis of myasthenia gravis. Acetylcholine receptor modulating antibodies are one of these. The other most common are the acetylcholine binding or blocking antibodies and the MUSK antibody. Not every patient with myasthenia gravis clinically has positive antibodies to the acetylcholine receptor that we can detect. The likelihood of positive tests is higher the more generalized the symptoms and the more severe the symptoms are. Antibodies do not correlate well with clinical severity, although I have seen some physicians use these tests to feel more comfortable about how well the disease is being controlled. Usually the clinical exam and the history is enough. Recently, there have been some studies looking at the antibodies and the effect of certain treatments, like thymectomy and immunosuppression. I would ask the physician why this decision was made so you feel more comfortable.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati