{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:37:56Z","timestamp":1782999476639,"version":"3.54.5"},"reference-count":115,"publisher":"BMJ","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Neurology, Neurosurgery & Psychiatry"],"published-print":{"date-parts":[[1980,7,1]]},"DOI":"10.1136\/jnnp.43.7.611","type":"journal-article","created":{"date-parts":[[2008,11,10]],"date-time":"2008-11-10T21:16:40Z","timestamp":1226351800000},"page":"611-621","source":"Crossref","is-referenced-by-count":21,"title":["Immune disease and HLA associations with myasthenia gravis."],"prefix":"10.1136","volume":"43","author":[{"given":"P O","family":"Behan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","reference":[{"key":"ref_1","article-title":"Histocompatibility antigens Our understanding of several chronic diseases has recently been increased by the discovery that there is a genetic component to their development. This has been shown by demonstrating that certain histocompatibility antigens have an association with particular diseases. Histocompatibility (HLA) antigens are cell-surface components present in the membrane of most, but not all, cells in varying amounts. For practical purposes in humans, leucocytes are used to identify these antigens: indeed they were the source of the first tissue antigens recognized and gave their name to the system: HLA system-human leucocyte antigen system","unstructured":"Histocompatibility antigens Our understanding of several chronic diseases has recently been increased by the discovery that there is a genetic component to their development. This has been shown by demonstrating that certain histocompatibility antigens have an association with particular diseases. Histocompatibility (HLA) antigens are cell-surface components present in the membrane of most, but not all, cells in varying amounts. For practical purposes in humans, leucocytes are used to identify these antigens: indeed they were the source of the first tissue antigens recognized and gave their name to the system: HLA system-human leucocyte antigen system."},{"key":"ref_2","article-title":"Further confirmation of the striking relationship between HLA-B8 and myasthenia gravis was obtained by an analysis of 56 cases which included seven Negro and Indian patients.47 In these two races HLA-B8 is quite uncommon yet the three young females were all HLA-B8 positive. Patients in the group were also subdivided on the basis of their thymic pathology. Although the number of cases was small it appeared that it was females with thymic hyperplasia in whom","volume-title":"cases), not those with a thymoma","year":"16","unstructured":"Further confirmation of the striking relationship between HLA-B8 and myasthenia gravis was obtained by an analysis of 56 cases which included seven Negro and Indian patients.47 In these two races HLA-B8 is quite uncommon yet the three young females were all HLA-B8 positive. Patients in the group were also subdivided on the basis of their thymic pathology. Although the number of cases was small it appeared that it was females with thymic hyperplasia in whom the association with HLA-B8 was cxpressed (nine of 16 cases), not those with a thymoma."},{"key":"ref_3","article-title":"This work was confirmed in the 1977 histocompatibility workshop'03 where HLA antigens and thymic pathology were compared in 106","unstructured":"This work was confirmed in the 1977 histocompatibility workshop'03 where HLA antigens and thymic pathology were compared in 106"},{"key":"ref_4","first-page":"3","article-title":"Tumours of the thyroid gland in relation to some general concepts of neoplasia","volume":"10","author":"Smithers, D.W.","year":"1959","unstructured":"Smithers DW. Tumours of the thyroid gland in relation to some general concepts of neoplasia. J Radiol 1959; 10:3.","journal-title":"J Radiol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/0002-9343(59)90248-7","article-title":"Search for a neuromuscular blocking agent in the blood of patients with myasthenia gravis","volume":"26","author":"Nastuk, W.L.; Strauss, A.J.L.; Osserman, K.E.","year":"1959","unstructured":"Nastuk WL, Strauss AJL, Osserman KE. Search for a neuromuscular blocking agent in the blood of patients with myasthenia gravis. Am J Med 1959; 26:394-409.","journal-title":"Am J Med"},{"key":"ref_6","first-page":"177","article-title":"Changes in serum complement activity in patients","volume-title":"with myasthenia gravis. Proc Soc Exp Biol Med 1960","volume":"105","author":"Nastuk, W.L.; Plescia, O.J.; Osserman, K.E.","unstructured":"Nastuk WL, Plescia OJ, Osserman KE. Changes in serum complement activity in patients with myasthenia gravis. Proc Soc Exp Biol Med 1960; 105:177-84."},{"key":"ref_7","first-page":"135","article-title":"Reduction in serum complement concentration","volume-title":"myasthenia gravis. Fed Proc 1956; 15","author":"Nastuk, W.L.; Osserman, K.E.; Plescia, O.J.","unstructured":"Nastuk WL, Osserman KE, Plescia OJ. Reduction in serum complement concentration in myasthenia gravis. Fed Proc 1956; 15:135-6."},{"key":"ref_8","first-page":"184","article-title":"Immunofluorescence demonstration of a muscle binding, complement fixing serum globulin fraction","volume-title":"myasthenia gravis. Proc Soc Exp Biol Med 1960","volume":"105","author":"Strauss, A.J.K.; Segal, B.C.; Hsu, K.C.; Burkholder, P.M.; Nastuk, W.L.; Osserman, K.E.","unstructured":"Strauss AJK, Segal BC, Hsu KC, Burkholder PM, Nastuk WL, Osserman KE. Immunofluorescence demonstration of a muscle binding, complement fixing serum globulin fraction in myasthenia gravis. Proc Soc Exp Biol Med 1960; 105:184-91."},{"issue":"5","key":"ref_9","first-page":"419","article-title":"Myasthenia gravis. A new hypothesis","volume":"1960","author":"Simpson, J.A.","unstructured":"Simpson JA. Myasthenia gravis. A new hypothesis. Scot Med J 1960; 5:419-36.","journal-title":"Scot Med J"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1001\/archinte.1967.00300050073012","article-title":"Myasthenia gravis, chronic lymphocytic leukaemia and autoimmune hemolytic anaemia","volume":"120","author":"Cohen, S.M.; Waxman, S.","year":"1967","unstructured":"Cohen SM, Waxman S. Myasthenia gravis, chronic lymphocytic leukaemia and autoimmune hemolytic anaemia. Arch Intern Med 1967; 120:717-20.","journal-title":"Arch Intern Med"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1111\/j.1749-6632.1976.tb47715.x","article-title":"Thymectomy in myasthenia gravis: pathologic, clinical and electrophysiological correlations","volume":"274","author":"Papatestas, A.E.; Genkins, G.; Horowitz, S.H.; Kornfeld, P.","year":"1976","unstructured":"Papatestas AE, Genkins G, Horowitz SH, Kornfeld P. Thymectomy in myasthenia gravis: pathologic, clinical and electrophysiological correlations. Ann NY Acad Sci 1976; 274: 555-73.","journal-title":"Ann NY Acad Sci"},{"key":"ref_12","article-title":"The production of antibodies","author":"Burnett, F.M.; Fenner, F.","year":"1949","unstructured":"Burnett FM, Fenner F. The production of antibodies. London: Macmillan, 1949."},{"key":"ref_13","first-page":"43","article-title":"Are autoimmune diseases immunologic deficiency states? Hosp Pract","volume":"3","author":"Fudenberg, H.H.","year":"1968","unstructured":"Fudenberg HH. Are autoimmune diseases immunologic deficiency states? Hosp Pract 1968; 3:43-53."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0140-6736(71)92306-3","article-title":"Cooperating and controlling functions of thymus derived lymphocytes in relation to autoimmunity","volume":"ii:","author":"Allison, A.C.; Denman, T.M.; Barnes, R.D.","year":"1971","unstructured":"Allison AC, Denman TM, Barnes RD. Cooperating and controlling functions of thymus derived lymphocytes in relation to autoimmunity. Lancet 1971; ii:135-40.","journal-title":"Lancet"},{"key":"ref_15","first-page":"437","article-title":"Recent observations and concepts in immunological unresponsiveness and autoimmunity. Clin Exp Immunol","volume":"9","author":"Weigle, W.O.","year":"1971","unstructured":"Weigle WO. Recent observations and concepts in immunological unresponsiveness and autoimmunity. 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Clin Exp Immunol 1976; 26: 118-23."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1136\/jnnp.42.1.29","article-title":"Lymphocyte subpopulations in thymus and blood from patients with myasthenia gravis","volume":"42","year":"1979","unstructured":"Aarli JA, Heiman P, Matre R, Thunold S, Tonder 0. Lymphocyte subpopulations in thymus and blood from patients with myasthenia gravis. J Neurol Neurosurg Psychiatry 1979; 42:29-34.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1111\/j.1749-6632.1976.tb47701.x","article-title":"Aspects of lymphocyte function in myasthenia gravis","volume":"274","author":"Lisak, R.P.; Abdou, N.I.; Zweiman, B.; Zmijewski, C.; Penn, A.","year":"1976","unstructured":"Lisak RP, Abdou NI, Zweiman B, Zmijewski C, Penn A. Aspects of lymphocyte function in myasthenia gravis. 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Subpopulations of T lymphocytes in myasthenia gravis. Clin Exp Immunol 1979; 36:85-9."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5150","DOI":"10.1073\/pnas.75.10.5150","article-title":"Direct evidence for loss of human suppressor cells during active autoimmune disease","volume":"75","author":"Strelkauskas, A.J.; Callery, R.T.; McDowell, J.; Borel, Y.; Schlossman, S.F.","year":"1978","unstructured":"Strelkauskas AJ, Callery RT, McDowell J, Borel Y, Schlossman SF. Direct evidence for loss of human suppressor cells during active autoimmune disease. Proc Natl Acad Sci 1978; 75: 5150-4.","journal-title":"Proc Natl Acad Sci"},{"key":"ref_36","first-page":"\"pp 233","article-title":"Disorders of the suppressor cell system","volume":"88","author":"Krakauer, R.S.","year":"1978","unstructured":"Krakauer RS. Disorders of the suppressor cell system. In: Autoimmunity, pp 233-6 in: Waldermann TA (Moderator): Disorders of suppressor immunoregulatory cells in the pathogenesis of immunodeficiency and autoimmunity. Ann Intern Med 1978; 88:226-38.","journal-title":"Ann Intern Med; in: Waldermann TA (Moderator): Disorders of suppressor immunoregulatory cells in the pathogenesis of immunodeficiency and autoimmunity"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1056\/NEJM197909203011202","article-title":"Identification of two serum components regulating the expression of T-lymphocyte function in childhood myasthenia gravis","volume":"301","author":"Shore, A.; Limatibul, S.; Dosch, H.; Gelfand, E.W.","year":"1979","unstructured":"Shore A, Limatibul S, Dosch H, Gelfand EW. Identification of two serum components regulating the expression of T-lymphocyte function in childhood myasthenia gravis. 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Role of complement in the pathogenesis of experimental autoimmune myasthenia gravis. J Exp Med 1978; 147:973-83.","journal-title":"J Exp Med"},{"key":"ref_40","first-page":"267","article-title":"Immune complexes (IgG and C3) at the motor endplate in myasthenia gravis: ultrastructural and light microscopic localisation and electrophysiological conditions","volume-title":"Mayo Clin Proc","volume":"52","author":"Engel, A.G.; Lambert, E.H.; Howard, F.M.","year":"1977","unstructured":"Engel AG, Lambert EH, Howard FM. Immune complexes (IgG and C3) at the motor endplate in myasthenia gravis: ultrastructural and light microscopic localisation and electrophysiological conditions. Mayo Clin Proc 1977; 52:267-80."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1016\/S0140-6736(54)92441-1","article-title":"Surgery of the thymus gland. Second (and third) thoughts","volume":"1","author":"Keynes, G.","year":"1954","unstructured":"Keynes G. Surgery of the thymus gland. Second (and third) thoughts. Lancet 1954; 1:1197-202.","journal-title":"Lancet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1136\/jnnp.42.7.595","article-title":"Immune complexes in myasthenia gravis","volume":"42","author":"Behan, W.M.H.; Behan, P.O.","year":"1979","unstructured":"Behan WMH, Behan PO. Immune complexes in myasthenia gravis. J Neurol Neurosurg Psychiatry 1979; 42:595-9.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/00005072-197803000-00008","article-title":"Ultrastructural localisation of immune complexes (IgG and C3) at the endplate of experimental autoimmune myasthenia gravis","volume":"37","author":"Sahashi, K.; Engel, A.G.; Lindstrom, J.M.; Lambert, E.H.; Lennon, V.A.","year":"1978","unstructured":"Sahashi K, Engel AG, Lindstrom JM, Lambert EH, Lennon VA. 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On evaluation of undulating immune complexes in myasthenia gravis. 1979 (in preparation)."},{"key":"ref_46","article-title":"Current status","volume-title":"of the epidemiology and genetics of myasthenia gravis","author":"Kurland, L.T.; Alter, M.","year":"1961","unstructured":"Kurland LT, Alter M. Current status of the epidemiology and genetics of myasthenia gravis. In: Viets HR, ed. Myasthenia gravis. Springfield: Chas C Thomas, 1961."},{"key":"ref_47","article-title":"Diseases of the nervous system. Second edition. Translated by Mayer EE","author":"Oppenheim, H.","year":"1900","unstructured":"Oppenheim H. Diseases of the nervous system. Second edition. Translated by Mayer EE. Philadelphia: JP Lippincott, 1900."},{"key":"ref_48","article-title":"New contribution to pathogenesis of myasthenia. Bull Mem Soc Medl Paris 1925; 49","author":"Marinesco, G.","year":"1369","unstructured":"Marinesco G. New contribution to pathogenesis of myasthenia. Bull Mem Soc Medl Paris 1925; 49:1369."},{"key":"ref_49","first-page":"304","article-title":"Histocompatibility antigens (HL-A) associated with myasthenia gravis","volume":"4","author":"Pirskanen, R.; Tiilikainen, A.; Hokkanen, E.","year":"1972","unstructured":"Pirskanen R, Tiilikainen A, Hokkanen E. Histocompatibility antigens (HL-A) associated with myasthenia gravis. Ann Clin Res 1972; 4: 304-6.","journal-title":"Ann Clin Res"},{"key":"ref_50","first-page":"240","article-title":"HL-A antigens in myasthenia gravis","volume":"1","author":"Fritze, D.; Herrmann, C.; Naeim, F.; Smith, G.S.; Walford, R.L.","year":"1974","unstructured":"Fritze D, Herrmann C, Naeim F, Smith GS, Walford RL. HL-A antigens in myasthenia gravis. Lancet 1974; 1:240-3.","journal-title":"Lancet"},{"key":"ref_51","article-title":"Immune responses genes in myasthenia gravis","author":"Behan, P.O.; Simpson, J.A.; Dick, H.M.","year":"1973","unstructured":"Behan PO, Simpson JA, Dick HM. 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