Semin Neurol. 2004;24(1) 

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Treatment of Seronegative Patients

For years the management of MG patients seronegative for acetylcholine receptor antibodies has not differed from that of seropositive patients. For the most part, this is still true, but recent findings are modifying our approach to seronegative patients. A proportion of seronegative patients will have antibodies against muscle specific tyrosine kinase (MuSK). The percentage of seronegative patients who are MuSK-positive has ranged from 38 to 71%.[73,74,75] Only limited data are available for MuSK-positive patients, but they appear to have a variable response to pyridostigmine, excellent response to plasmapheresis, and an overall good response to immunosuppressant medications.[75] In the small number of patients studied to date, there has not been improvement after thymectomy.[75]