Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Anti-MuSK positive myasthenia gravis with anti-Lrp4 and anti-titin antibodies
Rika YamashitaMikito ShimizuKousuke BabaGoichi BeckMakoto KinoshitaTatsusada OkunoOsamu HiguchiHideki Mochizuki
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JOURNALS OPEN ACCESS Advance online publication

Article ID: 4957-20


In addition to muscle nicotinic acetylcholine receptor (AChR) and muscle-specific kinase (MuSK), low-density lipoprotein receptor (Lrp4) has recently been discovered to be a novel target antigen among patients with seronegative myasthenia gravis (MG). We herein report the findings of a 62-year-old patient who showed positivity for anti-MuSK, anti-Lrp4, and anti-titin antibodies. The patient developed MG crisis following a 10-year history of intermittent double vision with ptosis, and a 7-year history of dropped head. Our detailed clinical, laboratory, and therapeutic descriptions highlight its unique characteristics of anti-MuSK-antibody positive MG accompanied by anti-Lrp4 and anti-titin antibodies.

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© 2021 by The Japanese Society of Internal Medicine
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