{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:53:18Z","timestamp":1791553998674,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82101422"],"award-info":[{"award-number":["82101422"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Immunity Inflam &amp;amp; Disease"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. The muscle\u2010specific kinase (MuSK) antibody\u2010positive subtype often involves bulbar and respiratory muscles, conferring a high risk of myasthenic crisis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We report a very late\u2010onset MuSK\u2010MG case complicated by lung infection and acute heart failure, with a history of peptic ulcer. The patient was sequentially treated with efgartigimod and telitacicept, achieving minimal symptom expression (MSE) within 1.5\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Following the first efgartigimod infusion, QMG and MG\u2010ADL scores improved from 31 to 23 and 22 to 12, respectively. After five injections of telitacicept, symptoms resolved completely on day 47, with scores further reducing to 2 (QMG) and 0 (MG\u2010ADL). Treatment also reduced IgG levels and MuSK\u2010Ab titers, while IgM remained stable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates the successful sequential use of efgartigimod and telitacicept in managing complicated, late\u2010onset MuSK\u2010MG in a state of impeding crisis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/iid3.70521","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:32:45Z","timestamp":1791552765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Sequential Regimen of Efgartigimod and Telitacicept as Fast\u2010Acting Treatment for Impeding Crisis of MuSK\u2010MG"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6816-4844","authenticated-orcid":false,"given":"Tianjiao","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Neurology, the Second Xiangya Hospital Central South University Changsha Hunan China"},{"name":"Clinical Medical Research Center for Stroke Prevention and Treatment of Hunan Province, Department of Neurology, the Second Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Neurology, the Affiliated Changsha Hospital of Xiangya School of Medicine Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Neurology, the Second Xiangya Hospital Central South University Changsha Hunan China"},{"name":"Clinical Medical Research Center for Stroke Prevention and Treatment of Hunan Province, Department of Neurology, the Second Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifan","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurology, the Second Xiangya Hospital Central South University Changsha Hunan China"},{"name":"Clinical Medical Research Center for Stroke Prevention and Treatment of Hunan Province, Department of Neurology, the Second Xiangya Hospital Central South University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcn152"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002790"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1212757"},{"issue":"3","key":"e_1_2_9_5_1","first-page":"241","article-title":"Expert Consensus on the Management of Impending Myasthenic Crisis","volume":"32","author":"Luo S. 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