{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:50:51Z","timestamp":1780581051828,"version":"3.54.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017700","name":"Henan Provincial Science and Technology Research Project","doi-asserted-by":"publisher","award":["LHGJ20240705"],"award-info":[{"award-number":["LHGJ20240705"]}],"id":[{"id":"10.13039\/501100017700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"DOI":"10.1186\/s12883-026-04726-7","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T14:07:04Z","timestamp":1771250824000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes, serum IgG changes, and follow-up observations in the treatment of anti-AChR antibody-positive generalized myasthenia gravis with Efgartigimod"],"prefix":"10.1186","volume":"26","author":[{"given":"Jingting","family":"Fu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianzhao","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianqian","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhao","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhua","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haidong","family":"Lyv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"issue":"10","key":"4726_CR1","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S1474-4422(15)00145-3","volume":"14","author":"NE Gilhus","year":"2015","unstructured":"Gilhus NE, Verschuuren JJ. Myasthenia gravis: subgroup classification and therapeutic strategies. Lancet Neurol. 2015;14(10):1023\u201336.","journal-title":"Lancet Neurol"},{"issue":"6","key":"4726_CR2","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1172\/JCI115253","volume":"87","author":"H Link","year":"1991","unstructured":"Link H, Olsson O, Sun J, Wang WZ, Andersson G, Ekre H, et al. Acetylcholine receptor-reactive T and B cells in myasthenia gravis and controls. J Clin Investig. 1991;87(6):2191\u20136.","journal-title":"J Clin Investig"},{"issue":"5","key":"4726_CR3","doi-asserted-by":"publisher","first-page":"e200436","DOI":"10.1212\/NXI.0000000000200436","volume":"12","author":"F Khani-Habibabadi","year":"2025","unstructured":"Khani-Habibabadi F, Roy B, Pham MC, Obaid AH, Filipek B, Nowak RJ, et al. AChR autoantibody pathogenic properties are heterogeneously distributed and undergo temporal changes among patients with myasthenia gravis. Neurol Neuroimmunol Neuroinflammation. 2025;12(5):e200436.","journal-title":"Neurol Neuroimmunol Neuroinflammation"},{"issue":"21","key":"4726_CR4","doi-asserted-by":"publisher","first-page":"6394","DOI":"10.3390\/jcm11216394","volume":"11","author":"D S\u00e1nchez-Tejerina","year":"2022","unstructured":"S\u00e1nchez-Tejerina D, Sotoca J, Llaurado A, L\u00f3pez-Diego V, Juntas-Morales R, Salvado M. New targeted agents in myasthenia gravis and future therapeutic strategies. J Clin Med. 2022;11(21):6394.","journal-title":"J Clin Med"},{"issue":"3","key":"4726_CR5","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.jaci.2020.07.016","volume":"146","author":"HH Peter","year":"2020","unstructured":"Peter HH, Ochs HD, Cunningham-Rundles C, Vinh DC, Kiessling P, Greve B, et al. Targeting FcRn for immunomodulation: benefits, risks, and practical considerations. J Allergy Clin Immunol. 2020;146(3):479\u201391.","journal-title":"J Allergy Clin Immunol"},{"issue":"3","key":"4726_CR6","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1002\/mus.28184","volume":"70","author":"L Remijn-Nelissen","year":"2024","unstructured":"Remijn-Nelissen L, Tannemaat MR, Ruiter AM, Campman YJ, Verschuuren JJ. Efgartigimod in refractory autoimmune myasthenia gravis. Muscle Nerve. 2024;70(3):325\u201332.","journal-title":"Muscle Nerve"},{"issue":"8","key":"4726_CR7","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.1002\/acn3.52142","volume":"11","author":"S Luo","year":"2024","unstructured":"Luo S, Jiang Q, Zeng W, Wang Q, Zou Z, Yu Y, et al. Efgartigimod for generalized myasthenia gravis: A multicenter real-world cohort study in China. Ann Clin Transl Neurol. 2024;11(8):2212\u201321.","journal-title":"Ann Clin Transl Neurol"},{"issue":"12","key":"4726_CR8","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1080\/1744666X.2022.2136167","volume":"18","author":"S Suzuki","year":"2022","unstructured":"Suzuki S, Uzawa A, Murai H. Efgartigimod for generalized myasthenia gravis with or without anti-acetylcholine receptor antibodies: a worldwide and Japanese perspective. Expert Rev Clin Immunol. 2022;18(12):1207\u201315.","journal-title":"Expert Rev Clin Immunol"},{"issue":"7","key":"4726_CR9","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/S1474-4422(21)00159-9","volume":"20","author":"JF Howard","year":"2021","unstructured":"Howard JF, Bril V, Vu T, Karam C, Peric S, Margania T, et al. Safety, efficacy, and tolerability of efgartigimod in patients with generalised myasthenia gravis (ADAPT): a multicentre, randomised, placebo-controlled, phase 3 trial. Lancet Neurol. 2021;20(7):526\u201336.","journal-title":"Lancet Neurol"},{"issue":"3","key":"4726_CR10","doi-asserted-by":"publisher","first-page":"1307","DOI":"10.1007\/s10072-023-07122-y","volume":"45","author":"R Frangiamore","year":"2024","unstructured":"Frangiamore R, Rinaldi E, Vanoli F, Andreetta F, Mantegazza R, Antozzi C. Efgartigimod improves triple-negative myasthenia gravis. Neurol Sci. 2024;45(3):1307\u20139.","journal-title":"Neurol Sci"},{"issue":"4","key":"4726_CR11","doi-asserted-by":"publisher","first-page":"e16189","DOI":"10.1111\/ene.16189","volume":"31","author":"R Frangiamore","year":"2024","unstructured":"Frangiamore R, Rinaldi E, Vanoli F, Andreetta F, Ciusani E, Bonanno S, et al. Efgartigimod in generalized myasthenia gravis: A real-life experience at a national reference center. Eur J Neurol. 2024;31(4):e16189.","journal-title":"Eur J Neurol"},{"issue":"5","key":"4726_CR12","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1002\/mus.27974","volume":"68","author":"N Katyal","year":"2023","unstructured":"Katyal N, Halldorsdottir K, Govindarajan R, Shieh P, Muley S, Reyes P, et al. Safety and outcomes with efgartigimod use for acetylcholine receptor-positive generalized myasthenia gravis in clinical practice. Muscle Nerve. 2023;68(5):762\u20136.","journal-title":"Muscle Nerve"},{"issue":"01","key":"4726_CR13","first-page":"1","volume":"28","author":"T Chang","year":"2021","unstructured":"Chang T. Chinese guidelines for the diagnosis and treatment of myasthenia gravis (2020 edition). Chin J Neuroimmunol Neurol. 2021;28(01):1\u201312.","journal-title":"Chin J Neuroimmunol Neurol"},{"key":"4726_CR14","doi-asserted-by":"publisher","first-page":"175628642312132","DOI":"10.1177\/17562864231213240","volume":"16","author":"H Wiendl","year":"2023","unstructured":"Wiendl H, Abicht A, Chan A, Della Marina A, Hagenacker T, Hekmat K, et al. Guideline for the management of myasthenic syndromes. Ther Adv Neurol Disord. 2023;16:17562864231213240.","journal-title":"Ther Adv Neurol Disord"},{"issue":"1","key":"4726_CR15","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s42466-019-0023-3","volume":"1","author":"H Stetefeld","year":"2019","unstructured":"Stetefeld H, Schroeter M. SOP myasthenic crisis. Neurol Res Pract. 2019;1(1):19.","journal-title":"Neurol Res Pract"},{"key":"4726_CR16","volume-title":"The Quantitative Myasthenia Gravis (QMG) Test: The Manual","author":"R Barohn","year":"2000","unstructured":"Barohn R, Herbelin L. The Quantitative Myasthenia Gravis (QMG) Test: The Manual. St. Paul: Myasthenia Gravis Foundation of America Inc; 2000."},{"issue":"7","key":"4726_CR17","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1212\/WNL.52.7.1487","volume":"52","author":"GI Wolfe","year":"1999","unstructured":"Wolfe GI, Herbelin L, Nations S, Foster B, Bryan W, Barohn R. Myasthenia gravis activities of daily living profile. Neurology. 1999;52(7):1487.","journal-title":"Neurology"},{"issue":"6","key":"4726_CR18","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1002\/mus.27476","volume":"65","author":"S Muppidi","year":"2022","unstructured":"Muppidi S, Silvestri NJ, Tan R, Riggs K, Leighton T, Phillips GA. Utilization of MG-ADL in myasthenia gravis clinical research and care. Muscle Nerve. 2022;65(6):630\u20139.","journal-title":"Muscle Nerve"},{"issue":"5","key":"4726_CR19","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1002\/mus.23988","volume":"49","author":"HD Katzberg","year":"2014","unstructured":"Katzberg HD, Barnett C, Merkies IS, Bril V. Minimal clinically important difference in myasthenia gravis: outcomes from a randomized trial. Muscle Nerve. 2014;49(5):661\u20135.","journal-title":"Muscle Nerve"},{"issue":"1","key":"4726_CR20","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1186\/s12967-021-02961-9","volume":"19","author":"R Zhao","year":"2021","unstructured":"Zhao R, Wang Y, Huan X, Zhong H, Zhou Z, Xi J, et al. Nomogram for short-term outcome assessment in AChR subtype generalized myasthenia gravis. J Transl Med. 2021;19(1):285.","journal-title":"J Transl Med"},{"key":"4726_CR21","doi-asserted-by":"crossref","unstructured":"Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America, Jaretzki\u00a0III A, Barohn RJ, Ernstoff RM, Kaminski HJ, Keesey JC, Penn AS, Sanders DB. Myasthenia gravis: recommendations for clinical research standards. Neurology. 2000;55(1):16\u201323.","DOI":"10.1212\/WNL.55.1.16"},{"issue":"9","key":"4726_CR22","doi-asserted-by":"publisher","first-page":"6209","DOI":"10.1007\/s00415-024-12588-7","volume":"271","author":"C Pane","year":"2024","unstructured":"Pane C, Di Stefano V, Cuomo N, Sarnataro A, Vinciguerra C, Bevilacqua L, et al. A real-life experience with eculizumab and efgartigimod in generalized myasthenia gravis patients. J Neurol. 2024;271(9):6209\u201319.","journal-title":"J Neurol"},{"key":"4726_CR23","doi-asserted-by":"publisher","first-page":"114603","DOI":"10.1016\/j.intimp.2025.114603","volume":"154","author":"J Chen","year":"2025","unstructured":"Chen J, Zhu X, Zhou H, Huang W, Wu W, Chen C, et al. Efficacy of multi-cycle Efgartigimod in achieving minimal symptom expression in myasthenia gravis: A comparative multi-center study. Int Immunopharmacol. 2025;154:114603.","journal-title":"Int Immunopharmacol"},{"issue":"23","key":"4726_CR24","doi-asserted-by":"publisher","first-page":"e2661","DOI":"10.1212\/WNL.0000000000007600","volume":"92","author":"JF Howard Jr","year":"2019","unstructured":"Howard JF Jr, Bril V, Burns TM, Mantegazza R, Bilinska M, Szczudlik A, et al. Randomized phase 2 study of FcRn antagonist efgartigimod in generalized myasthenia gravis. Neurology. 2019;92(23):e2661\u201373.","journal-title":"Neurology"},{"issue":"4","key":"4726_CR25","doi-asserted-by":"publisher","first-page":"e70391","DOI":"10.1111\/cns.70391","volume":"31","author":"S Hao","year":"2025","unstructured":"Hao S, Ruan Z, Guo R, Wang Q, Huang X, Sun C, et al. Efficacy and Safety of Efgartigimod for Patients With Myasthenia Gravis in a Real-World Cohort of 77 Patients. CNS Neurosci Ther. 2025;31(4):e70391.","journal-title":"CNS Neurosci Ther"},{"issue":"1","key":"4726_CR26","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1186\/s12883-024-03804-y","volume":"24","author":"H Ohara","year":"2024","unstructured":"Ohara H, Kikutsuji N, Iguchi N, Kinoshita M. Efgartigimod combined with steroids as a fast-acting therapy for myasthenic crisis: a case report. BMC Neurol. 2024;24(1):292.","journal-title":"BMC Neurol"},{"key":"4726_CR27","doi-asserted-by":"publisher","first-page":"1418503","DOI":"10.3389\/fimmu.2024.1418503","volume":"15","author":"J Song","year":"2024","unstructured":"Song J, Wang H, Huan X, Jiang Q, Wu Z, Yan C, et al. Efgartigimod as a promising add-on therapy for myasthenic crisis: a prospective case series. Front Immunol. 2024;15:1418503.","journal-title":"Front Immunol"},{"issue":"2","key":"4726_CR28","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1002\/mus.28178","volume":"70","author":"F Sun","year":"2024","unstructured":"Sun F, Batra A, Dickson D, Li Y, Wu EL. Efgartigimod infusion in the treatment regimen for myasthenic crisis: A case report. Muscle Nerve. 2024;70(2):290\u20132.","journal-title":"Muscle Nerve"},{"issue":"1","key":"4726_CR29","first-page":"9455237","volume":"2024","author":"O Alhaj Omar","year":"2024","unstructured":"Alhaj Omar O, Diel NJ, Gerner ST, M\u00fcck A, Huttner HB, Kr\u00e4mer-Best HH. Efgartigimod as Rescue Medication in a Patient with Therapy-Refractory Myasthenic Crisis. Case Rep Neurol Med. 2024;2024(1):9455237.","journal-title":"Case Rep Neurol Med"},{"key":"4726_CR30","doi-asserted-by":"publisher","first-page":"1321058","DOI":"10.3389\/fneur.2024.1321058","volume":"15","author":"K Watanabe","year":"2024","unstructured":"Watanabe K, Ohashi S, Watanabe T, Kakinuma Y, Kinno R. Case report: recovery from refractory myasthenic crisis to minimal symptom expression after add-on treatment with efgartigimod. Front Neurol. 2024;15:1321058.","journal-title":"Front Neurol"},{"key":"4726_CR31","doi-asserted-by":"publisher","first-page":"175628642412548","DOI":"10.1177\/17562864241254895","volume":"17","author":"Z Zhang","year":"2024","unstructured":"Zhang Z, Yang M, Luo T, Du X, Wang Z, Huang X, et al. Rescue treatment with add-on efgartigimod in a patient with impending myasthenic crisis: a case report. Ther Adv Neurol Disord. 2024;17:17562864241254896.","journal-title":"Ther Adv Neurol Disord"},{"issue":"3","key":"4726_CR32","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.jaci.2020.07.016","volume":"146","author":"HH Peter","year":"2020","unstructured":"Peter HH, Ochs HD, Cunningham-Rundles C, Vinh DC, Kiessling P, Greve B, et al. Targeting FcRn for immunomodulation: benefits, risks, and practical considerations. J Allergy Clin Immunol. 2020;146(3):479\u201391.","journal-title":"J Allergy Clin Immunol"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-026-04726-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04726-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-04726-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T07:58:07Z","timestamp":1773820687000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12883-026-04726-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4726"],"URL":"https:\/\/doi.org\/10.1186\/s12883-026-04726-7","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"6 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This research adhered to the ethical guidelines set forth in the Declaration of Helsinki and was approved by the Ethics Committee at Jiaozuo People\u2019s Hospital Affiliated of Xinxiang Medical University (approval No. 2025-013-K13). Due to the retrospective nature of the study, the requirement for written informed consent for the utilization of clinical data was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors have approved the final version of the manuscript and consent to its publication. Given the retrospective nature of this study, the data used were de-identified (e.g., no names, medical record numbers, or other directly identifiable information were included), and only aggregated or anonymized information (such as gender, age ranges, and disease duration) was presented. Therefore, specific informed consent for publication is not required, as the risk of identifying individual participants is negligible. This approach is consistent with the ethical approval from the Ethics Committee at Jiaozuo People\u2019s Hospital Affiliated of Xinxiang Medical University.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"173"}}