{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:27:34Z","timestamp":1783006054635,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T00:00:00Z","timestamp":1476316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Watney\/MGA\/Oxford Biomedical Research Centre"},{"name":"NHS National Specialised Commissioning Group for Neuromyelitis Optica, UK"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In this study we determined the frequencies of antibodies (Abs) directed against muscle\u2010specific kinase (MuSK) and lipoprotein receptor\u2013related protein 4 (LRP4) in the sera of a South African cohort with acetylcholine receptor (AChR)\u2010antibody\u2013negative generalized MG and determined outcomes to therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sera negative by commercial AChR radioimmunoassay (RIA) were tested by MuSK RIA (<jats:italic>n<\/jats:italic>\u2009=\u200930; 2006\u20132012) and AChR, MuSK, and LRP4 RIA with or without cell\u2010based assays (CBA) (<jats:italic>n<\/jats:italic>\u2009=\u200953; 2012\u20132015).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>AChR\u2010Abs were detected in 4 of 53 and MuSK\u2010Abs in 20 of 83 (24%) cases. Thirty\u2010six of 53 (68%) were triple seronegative (triple\u2010SNMG) for MuSK, AChR, and LRP4\u2010Abs. When compared with triple\u2010SNMG, individuals with MuSK\u2010MG had a younger onset age (<jats:italic>P<\/jats:italic>\u2009=\u20090.008), a greater likelihood of African genetic ancestry (<jats:italic>P<\/jats:italic>\u2009=\u20090.008), and 4\u2010fold higher odds of reaching MGFA grade IVB\/V (<jats:italic>P<\/jats:italic>\u2009=\u20090.018), but were also 9\u2010fold more likely to reach at least minimal manifestations status after \u226512 months of therapy (<jats:italic>P<\/jats:italic>\u2009=\u20090.003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Individuals with African genetic ancestry and severe bulbar\/respiratory AChR\u2010Ab\u2013negative MG are likely to have MuSK\u2010MG, but most respond favorably to maintenance immunotherapies.  <jats:italic>Muscle Nerve<\/jats:italic> <jats:bold>54<\/jats:bold>: 1023\u20131029, 2016<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.25154","type":"journal-article","created":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T23:11:11Z","timestamp":1461366671000},"page":"1023-1029","source":"Crossref","is-referenced-by-count":39,"title":["Characteristics Of acetylcholine\u2010receptor\u2010antibody\u2013negative myasthenia gravis in a South African cohort"],"prefix":"10.1002","volume":"54","author":[{"given":"Saif","family":"Huda","sequence":"first","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark R.","family":"Woodhall","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Vincent","sequence":"additional","affiliation":[{"name":"Nuffield Department of Clinical Neurosciences University of Oxford, John Radcliffe Hospital Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannine M.","family":"Heckmann","sequence":"additional","affiliation":[{"name":"Division of Neurology, E8\u201074, Department of Medicine University of Cape Town  South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,10,13]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2008.02176.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.102517"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.22006"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg223"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn092"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.0203"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000478"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6194-7"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2013.12.004"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21191"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2007.07.002"},{"key":"e_1_2_6_13_1","first-page":"959","article-title":"Incidence of seropositive myasthenia gravis in Cape Town and South Africa","volume":"97","author":"Bateman KJ","year":"2007","journal-title":"S Afr Med J"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24348"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20854"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.5390"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2006.108498"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhg.2015.146"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/gene.2009.61"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2014.02.010"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22312"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2012.06833.x"},{"key":"e_1_2_6_24_1","first-page":"765","article-title":"High\u2010dose immunosuppressive therapy in generalised myasthenia gravis\u2014a 2\u2010year follow\u2010up study","volume":"91","author":"Heckmann JM","year":"2001","journal-title":"S Afr Med J"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-11-97"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000254620.45529.97"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/CND.0b013e318275197c"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2015.04.015"}],"container-title":["Muscle &amp; 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