{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:12:55Z","timestamp":1786515175767,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,8]],"date-time":"2024-08-08T00:00:00Z","timestamp":1723075200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"Abstract<\/jats:title>Background and Purpose<\/jats:title>Acetylcholine receptor antibody (AChR\u2010Ab) detection is crucial in myasthenia gravis (MG) diagnosis and, currently, the radioimmunoassay (RIA) is the gold standard. However, RIA may detect AChR\u2010Ab against nonpathogenic intracellular epitopes. In this study, we performed fixed cell\u2010based assay (F\u2010CBA) in RIA\u2010AChR\u2010Ab positive subjects without MG symptoms, to assess whether F\u2010CBA could show a higher specificity compared to RIA in detecting pathogenic Abs.<\/jats:p><\/jats:sec>Methods<\/jats:title>We reviewed medical records of patients referred to our MG outpatient clinic because of RIA\u2010AChR\u2010Ab detection. MG diagnosis was based on clinical examination, electrophysiology and Ab detection. AChR\u2010Abs were tested by RIA in the whole cohort. Serum samples from RIA\u2010positive asymptomatic subjects were retested by F\u2010CBA.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 605 subjects who tested RIA\u2010AChR\u2010Ab positive, MG diagnosis was confirmed in 599. Six subjects were RIA\u2010AChR\u2010Ab positive although they had never had MG symptoms; in four of these subjects AChR\u2010Abs were not detected by F\u2010CBA, whereas the remaining two (both non\u2010MG thymoma cases) were positive also by F\u2010CBA.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>RIA false positivity for AChR\u2010Ab is very rare. Previous literature has demonstrated that F\u2010CBA has higher sensitivity than RIA for MG, especially in ocular cases. Our preliminary results show that, in rare instances, F\u2010CBA may be more specific than RIA for MG diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16435","type":"journal-article","created":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T02:59:39Z","timestamp":1723172379000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Concordance between radioimmunoassay and fixed cell\u2010based assay in subjects without myasthenia gravis: optimizing the diagnostic approach"],"prefix":"10.1111","volume":"31","author":[{"given":"Silvia","family":"Falso","sequence":"first","affiliation":[{"name":"Department of Neuroscience Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Marini","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Carrozza","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Clinical Biochemistry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8604-7544","authenticated-orcid":false,"given":"Eleonora","family":"Sabatelli","sequence":"additional","affiliation":[{"name":"Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Mascagna","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Clinical Biochemistry Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Marini","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Morroni","sequence":"additional","affiliation":[{"name":"Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4644-2299","authenticated-orcid":false,"given":"Amelia","family":"Evoli","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"},{"name":"Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6270-0956","authenticated-orcid":false,"given":"Raffaele","family":"Iorio","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Universit\u00e0 Cattolica del Sacro Cuore Rome Italy"},{"name":"Neurology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0079-y"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10342-3"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.2833-09.2009"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2012.437"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12270"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.0203"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2022-329284"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2022.577850"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000200038"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-023-00916-w"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneuroim.2019.04.001"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2020.12.010"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2019-002494"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2023.100846"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.120084"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T04:45:40Z","timestamp":1757565940000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,8]]},"references-count":15,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/ene.16435"],"URL":"https:\/\/doi.org\/10.1111\/ene.16435","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,8]]},"assertion":[{"value":"2024-03-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16435"}}