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AChR-binding antibodies; AChR-blocking antibodies; striational antibodies
Diagnose acquired myasthenia gravis1
AChR autoantibodies are not typically found in congenital myasthenia.
This procedure may be considered by Medicare and other carriers as investigational and, therefore, may not be payable as a covered benefit for patients.
See individual tests.
Myasthenia gravis is an acquired disorder of neuromuscular transmission characterized by use-associated muscle weakness and fatigability.1 This condition frequently involves the extraocular muscles and has a strong association with tumor of the thymus (thymoma). The disease has a prevalence of approximately 5 per 100,000 individuals and can occur at any age. In women, the disease usually presents between the ages of 20 and 40 years, while disease onset in men typically occurs later in life.
Autoantibodies to postsynaptic acetylcholine receptors are detectable in the serum of 90% of patients with generalized myasthenia gravis and approximately 70% of patients with ocular myasthenia.1 These autoantibodies interfere with normal neuromuscular function, causing muscle weakness and fatigue. Antibody titers tend to be higher in females and a correlation between antibody titer and degree of muscle weakness has been observed in individual patients. Receptor antibody titers tend to rise several weeks before exacerbations in patients with established myasthenia gravis. Remission after thymectomy is associated with a progressive decline in antibody titers. Consequently, serial measurements of acetylcholine receptor antibodies can be useful in monitoring disease progression as well as the effects of treatment.
Myasthenia gravis is often associated with striational antibody. AChR binding antibodies can also be positive in uncomplicated thymoma, Lambert-Eaton myasthenic syndrome, primary lung cancer and in patients with autoimmune liver disease.1
AChR blocking antibodies are observed in 52% of patients with autoimmune myasthenia gravis.1 These autoantibodies interfere with normal neuromuscular function, causing muscle weakness and fatigue. Approximately 1% of individuals are positive for AChR blocking antibodies in the absence of AChR binding antibodies.1
Striational antibodies are found in approximately 30% of patients with acquired myasthenia gravis.1 The rate of positivity increases with age of onset and 55% of individuals with disease onset after age 60 will have striational antibodies.1 These antibodies can be positive in myasthenia gravis patients in the absence of AChR antibodies.1
1 mL (Note: This volume does not allow for repeat testing.)
Red-top tube or gel-barrier tube
If a red-top tube is used, transfer separated serum to a plastic transport tube.
Causes for Rejection
Excessive hemolysis; chylous serum; recently administered isotopes; plasma specimen
|Order Code||Order Code Name||Order Loinc||Result Code||Result Code Name||UofM||Result LOINC|
|086122||Myasthenia Gravis Panel III||085904||AChR Binding Abs, Serum||nmol/L||11034-6|
|086122||Myasthenia Gravis Panel III||085927||AChR Blocking Abs, Serum||%||11561-8|
|086122||Myasthenia Gravis Panel III||161216||Anti-striation Abs||5372-8|