{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:03:21Z","timestamp":1789124601271,"version":"build-2803163510"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hospital-level Research Project of Qujing First People\u2019s Hospital","award":["2023YJKTB02"],"award-info":[{"award-number":["2023YJKTB02"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study aimed to investigate the clinical characteristics of patients with myasthenia gravis (MG) who are double-seropositive for acetylcholine receptor antibodies (AChR-Ab\n                      <jats:sup>+<\/jats:sup>\n                      ) and titin antibodies (Titin-Ab\n                      <jats:sup>+<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on MG patients hospitalized in the Department of Neurology between March 2020 and June 2024. Patients were categorized into two groups based on antibody profiles: those with AChR antibody positivity alone and those with dual positivity for AChR and titin antibodies. Clinical features, MG classification, and treatment outcomes were compared between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 35 MG patients were included, comprising 18 with single AChR-Ab\n                      <jats:sup>+<\/jats:sup>\n                      and 17 with AChR-Ab\n                      <jats:sup>+<\/jats:sup>\n                      \/Titin-Ab\n                      <jats:sup>+<\/jats:sup>\n                      . The dual antibody-positive group showed a significantly higher proportion of patients with MGFA classification above Class II (47.1%) and a higher rate of thyroid dysfunction (50%) compared to the single antibody-positive group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). The median age of onset in the dual antibody-positive group was older than that in the single antibody-positive group (67.0\u202fyears vs. 58.5\u202fyears), although this difference was not statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). No significant differences were observed between the two groups in terms of gender, initial symptoms, clinical manifestations, thymic hyperplasia, proportion of thymoma, treatment regimens, or therapeutic outcomes (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study provides the first systematic characterization of the clinical profile of AChR-Ab\n                      <jats:sup>+<\/jats:sup>\n                      \/Titin-Ab\n                      <jats:sup>+<\/jats:sup>\n                      myasthenia gravis patients in Southwest China. Our findings indicate that dual antibody-positive MG patients are more prone to generalized disease involvement and have a higher susceptibility to thyroid dysfunction.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1679404","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T05:14:53Z","timestamp":1764306893000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical characteristics of myasthenia gravis patients with coexistence of AChR and titin antibodies"],"prefix":"10.3389","volume":"16","author":[{"given":"Siqi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Difang","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qijie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiwei","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjian","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xujun","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1016\/j.autrev.2013.03.001","article-title":"Pathophysiology of myasthenia gravis with antibodies to the acetylcholine receptor, muscle-specific kinase and low-density lipoprotein receptor-related protein 4","volume":"12","author":"Verschuuren","year":"2013","journal-title":"Autoimmun Rev"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S1474-4422(15)00145-3","article-title":"Myasthenia gravis: subgroup classification and therapeutic strategies","volume":"14","author":"Gilhus","year":"2015","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"596981","DOI":"10.3389\/fneur.2020.596981","article-title":"Myasthenia gravis: autoantibody specificities and their role in MG management","volume":"11","author":"Lazaridis","year":"2020","journal-title":"Front Neurol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1002\/mus.26985","article-title":"Clinical features of LRP4\/agrin-antibody-positive myasthenia gravis: a multicenter study","volume":"62","author":"Rivner","year":"2020","journal-title":"Muscle Nerve"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/25785826.2025.2472449","article-title":"Pathogenesis and detection methods of anti-acetylcholine receptor antibodies in myasthenia gravis","volume":"48","author":"Suzuki","year":"2025","journal-title":"Immunol Med"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.medcli.2023.04.006","article-title":"Myasthenia gravis. 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