1. False-positive acetylcholine receptor antibody results in patients without myasthenia gravis
- Author
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Saiju Jacob, Girija Sadalage, Philip Alexander Ambrose, Angela Vincent, and Paul Maddison
- Subjects
Adult ,Male ,0301 basic medicine ,Radioimmunoprecipitation Assay ,animal structures ,Immunology ,Cell ,Receptors, Nicotinic ,Guillain-Barre Syndrome ,Autoantigens ,Epitope ,Epitopes ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Antibody Specificity ,immune system diseases ,Myasthenia Gravis ,medicine ,Humans ,Immunology and Allergy ,False Positive Reactions ,Prospective Studies ,Diagnostic Errors ,Prospective cohort study ,Aged ,Autoantibodies ,Acetylcholine receptor ,biology ,business.industry ,Middle Aged ,musculoskeletal system ,medicine.disease ,Myasthenia gravis ,nervous system diseases ,030104 developmental biology ,medicine.anatomical_structure ,Neurology ,biology.protein ,Female ,Neurology (clinical) ,Symptom Assessment ,Antibody ,business ,tissues ,030217 neurology & neurosurgery ,Intracellular - Abstract
Acetylcholine receptor antibodies are very specific for myasthenia. During a large prospective cohort study of myasthenia, we encountered five patients, positive for acetylcholine receptor (AChR) antibodies by radioimmunoprecipitation assay (RIA), whose clinical course revealed diagnoses other than myasthenia. Two patients had transiently raised AChR antibodies associated with Guillain-Barré syndrome. Antibodies to clustered AChRs, in a live cell-based assay, were negative in all five patients, suggesting that results from the RIAs were false-positives. It is possible that the AChR antibodies detected by RIA in these cases were non-pathogenic, and directed to intracellular epitopes of the AChR.
- Published
- 2019