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BRIEF RESEARCH REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1545579
Myasthenia gravis with double-seropositive acetylcholine receptor and low-density lipoprotein receptor-related protein 4 antibodies combined with muscle atrophy: a case report and literature review
Provisionally accepted
Zheng Yueliang 1 Su Gongzhang 2 Li Yanlin 1
Li Xiaoli 1,3* Zhao Xuelu 1 Du Tong 1,3
Cong-Cong Wang 1,3
Ying Liu 1,3
Bin Liu 1,3
Duan Ruisheng 1,3- 1 Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
- 2 Department of Thoracic Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital,Shandong Lung Cancer Institute, Jinan, China
- 3 Shandong Provincial Key Medicine and Health Laboratory of Neuroimmunology (The First Affiliated Hospital of Shandong First Medical University), Jinan, China
Objective: To investigate the clinical characteristics and mechanisms of muscle atrophy in myasthenia gravis (MG) patients who are double-seropositive with acetylcholine receptor (AChR) antibodies and low-density lipoprotein receptor-related protein 4 (LRP4) antibodies.The clinical data, imaging characteristics, treatment methods, and prognosis of one case of MG with AChR/LRP4 antibodies complicated by muscle atrophy were analyzed. Literature on anti-AChR/LRP4 antibodies double-seropositive MG with muscle atrophy were reviewed.Clinically, anti-AChR/LRP4 antibodies double-seropositive MG is rare, often onset after middle age, more common in females, frequently involving bulbar muscles, severe symptoms, poor prognosis, and unrelated to thymoma. Muscle atrophy in MG is not only seen in muscle-specific tyrosine kinase (MuSK)-MG but also in AChR-MG and seronegative MG. The mechanism of muscle atrophy may be related to genetic, immune, and nutritional factors.
Keywords: Myasthenia Gravis, muscle atrophy, AChR antibody, LRP4 antibody, Neurology
Received: 15 Dec 2024; Accepted: 07 Apr 2025.
Copyright: © 2025 Yueliang, Gongzhang, Yanlin, Xiaoli, Xuelu, Tong, Wang, Liu, Liu and Ruisheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Li Xiaoli, Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong Province, China
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