Point sur les diagnostics de laboratoire dans la myasthénie

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Point sur les diagnostics de laboratoire dans la myasthénie

Message par Pboulanger »


Lu sur http://www.sciencedirect.com/science/ar ... 8115000807
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  • This is a review of the different clinical forms of auto-immune Myasthenia Gravis and includes both clinical descriptions, description or reference to the assays used with comments on the clinical outcome of these assays.
  • It addresses Lambert Eaton myasthenic syndrome, Acetylcholine Receptor antibody positive Myasthenia Gravis, MuSK positive myasthenia Gravis as well as LRP-4 antibodies and the group of striational antibodies titin, rapsyn, ryonadine and agrin.

This review describes the state of the art for the use of laboratory testing in myasthenia gravis.

The review brings a detailed description of the different clinical forms of auto-immune myasthenia and of the Lambert Eaton Myasthenic Syndrome (LEMS).
The stress the differences between the different forms of acquired (auto-immune) myasthenia.
Then they present a summary of the different antibodies found in the disease. They insist on the advantage of the RIPA assay to measure antibodies to the acetylcholine receptor.
They stress the different types of contribution of each of these antibodies to the clinical diagnosis. They also describe the methods to measure each of the specific antibodies that have recently permitted to split the diagnosis: Abs to omega-conotoxin receptor in Lambert Eaton Myasthenic Syndrome (LEMS), abs to the acetylcholine receptor (AchR) in MG, Abs to muscle specific tyrosine kinase (MuSK) in Ab negative MG, and Abs to low molecular weight receptor related low-density lipo protein-4 (LRP-4). They also broach over the striated antibodies, less frequent and clinically less useful such as anti-titin, -ryanodine, -agrin and -rapsyn.

This represent a 360° view of the field as presented in Toronto in October 2014.

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