{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:04:13Z","timestamp":1789365853533,"version":"build-2803163510"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To delineate the clinical characteristics, diagnostic criteria, therapeutic strategies, and prognosis of myasthenia gravis (MG) with thymoma-associated CRMP5\/CV2 antibody-positive paraneoplastic neurological syndrome (PNS), thereby enhancing clinical recognition of this rare overlapping autoimmune disorder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the clinical data of a 53-year-old male patient presenting with peripheral nerve injury as the initial manifestation, who was subsequently diagnosed with MG, invasive thymoma, and CRMP5\/CV2 antibody-positive PNS. A comprehensive review of the relevant international literature was also conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patient had a 2-year disease course, initially presenting with limb numbness and unsteady gait, and gradually developing dysarthria, dysphagia, diplopia, and myasthenic weakness with characteristic diurnal fluctuation (worsening in the evening and improving in the morning). According to the Myasthenia Gravis Foundation of America (MGFA) clinical classification, the patient was categorized as Class IIIb (moderate generalized MG with predominant oropharyngeal involvement) at baseline. Serological tests confirmed positive for acetylcholine receptor (AChR) antibody in serum, as well as CRMP5\/CV2 antibody in both serum and cerebrospinal fluid (CSF). Electrophysiological examinations revealed multiple peripheral nerve damage and a significant decremental response to low-frequency repetitive nerve stimulation (RNS). Chest CT demonstrated an invasive thymoma in the anterior mediastinum. The patient underwent thoracoscopic thymectomy, followed by sequential treatment with glucocorticoids, intravenous immunoglobulin and cyclophosphamide, as well as symptomatic supportive care and anti-infective management. After treatment, the neurological symptoms were significantly improved, and the condition remained stable during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MG with thymoma-associated CRMP5\/CV2 antibody-positive PNS represents a rare clinical entity with atypical onset and is highly susceptible to misdiagnosis. Combined detection of paraneoplastic antibodies and chest imaging is critical for early diagnosis, and thymectomy combined with standardized immunotherapy can effectively improve the clinical symptoms and long-term prognosis of patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1904729","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:39:07Z","timestamp":1789364347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Myasthenia gravis with thymoma-associated CRMP5\/CV2 antibody-positive paraneoplastic neurological syndrome: a case report and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Rui","family":"Hu","sequence":"first","affiliation":[{"name":"First Clinical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankui","family":"Li","sequence":"additional","affiliation":[{"name":"First Clinical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaping","family":"Jin","sequence":"additional","affiliation":[{"name":"First Clinical College of Ningxia Medical University","place":["Yinchuan, China"]},{"name":"School of Nursing, Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Ma","sequence":"additional","affiliation":[{"name":"First Clinical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Li","sequence":"additional","affiliation":[{"name":"First Clinical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"Yang","sequence":"additional","affiliation":[{"name":"First Clinical College of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, General Hospital of Ningxia Medical University","place":["Yinchuan, China"]},{"name":"Diagnosis and Treatment Engineering Technology Research Center of Nervous System Diseases of Ningxia Hui Autonomous Region","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1007\/s00415-025-12922-7","article-title":"Myasthenia gravis in 2025: five new things and four hopes for the future","volume":"272","author":"Binks","year":"2025","journal-title":"J Neurol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/S1474-4422(23)00369-1","article-title":"Neurological adverse events of immune checkpoint inhibitors and the development of paraneoplastic neurological syndromes","volume":"23","author":"Farina","year":"2024","journal-title":"Lancet Neurol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-021-10934-7","article-title":"Movement disorders associated with neuronal antibodies: a data-driven approach","volume":"269","author":"Sturchio","year":"2022","journal-title":"J Neurol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1212\/wnl.55.1.16","article-title":"Myasthenia gravis: recommendations for clinical research standards. 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