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- Rika Yamashita, Mikito Shimizu, Kousuke Baba, Goichi Beck, Makoto Kinoshita, Tatsusada Okuno, Osamu Higuchi, and Hideki Mochizuki.
- Department of Neurology, Osaka University Hospital, Japan.
- Intern. Med. 2021 Jan 1; 60 (1): 137-140.
AbstractIn addition to muscle nicotinic acetylcholine receptor (AChR) and muscle-specific kinase (MuSK), low-density lipoprotein receptor (Lrp4) has recently been discovered to be a novel target antigen among patients with seronegative myasthenia gravis (MG). We herein report the findings of a 62-year-old patient who showed positivity for anti-MuSK, anti-Lrp4, and anti-titin antibodies. The patient developed MG crisis following a 10-year history of intermittent double vision with ptosis, and a 7-year history of dropped head. Our detailed clinical, laboratory, and therapeutic descriptions highlight its unique characteristics of anti-MuSK-antibody positive MG accompanied by anti-Lrp4 and anti-titin antibodies.
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