ArticleJournal of neurology2021
MuSK-antibodies are associated with worse outcome in myasthenic crisis requiring mechanical ventilation.
Article in Journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach From the Writing Committee of the American Society for Apheresis: The Tenth Special Issue.Journal of clinical apheresis · 2026Guideline
- Comprehensive review on myasthenia gravis: patho-physiology, diagnosis, management strategies.Wiener medizinische Wochenschrift (1946) · 2026Review
- Immune checkpoint inhibitor-related myasthenia gravis, myocarditis and myositis: further insights.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Fast-acting treatment of myasthenic crisis with efgartigimod from the perspective of the neonatal intensive care unit.BMC neurology · 2025Article
- Agonist antibody to MuSK protects mice from MuSK myasthenia gravis.Proceedings of the National Academy of Sciences of the United States of America · 2024Article
- MuSK Myasthenia Gravis-Potential Pathomechanisms and Treatment Directed against Specific Targets.Cells · 2024Review
- Efgartigimod treatment in patients with anti-MuSK-positive myasthenia gravis in exacerbation.Frontiers in neurology · 2024Article
- Independent risk factors for in-hospital outcome of myasthenic crisis: a prospective cohort study.Therapeutic advances in neurological disorders · 2024Article
- Identifying patients at risk for myasthenic crisis with hemogram and inflammation-related laboratory parameters - a pilot study.Frontiers in neurology · 2024Article
- Clinical Features and Prognostic Analysis of MuSK-Antibody-Positive Myasthenia Gravis versus Double-Seropositive Myasthenia Gravis: A Single-Center Study from Central South China.Neuropsychiatric disease and treatment · 2024Article
- Predictive Factors for Poor Outcomes Associated with COVID-19 in a Retrospective Cohort of Myasthenia Gravis Patients.Journal of inflammation research · 2024Article
- Review
- Myasthenia gravis, respiratory function, and respiratory tract disease.Journal of neurology · 2023Review
- Clinical pitfalls and serological diagnostics of MuSK myasthenia gravis.Journal of neurology · 2023Article
- Analysis of length of stay and treatment emergent complications in hospitalized myasthenia gravis patients with exacerbation.BMC neurology · 2023Article
- Immunotherapies in MuSK-positive Myasthenia Gravis; an IgG4 antibody-mediated disease.Frontiers in immunology · 2023Review
- Myasthenia gravis treated in the neurology intensive care unit: a 14-year single-centre experience.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Seronegative myasthenic crisis: a multicenter analysis.Journal of neurology · 2022Article
- Independent risk factors for myasthenic crisis and disease exacerbation in a retrospective cohort of myasthenia gravis patients.Journal of neuroinflammation · 2022Observational
- Factors affecting minimal manifestation status induction in myasthenia gravis.Therapeutic advances in neurological disorders · 2022Article
Corrections and comments
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Authors and funding
28 authors at 13 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Myasthenic crisis (MC) is a life-threatening condition for patients with myasthenia gravis (MG). Muscle-specific kinase-antibodies (MuSK-ABs) are detected in ~ 6% of MG, but data on outcome of MuSK-MCs are still lacking. We made a subgroup analysis of patients who presented with MC with either acetylcholine-receptor-antibody positive MG (AchR-MG) or MuSK-MG between 2006 and 2015 in a retrospective German multicenter study. We identified 19 MuSK-AB associated MCs in 15 patients and 161 MCs in 144 patients with AchR-ABs only. In contrast to patients with AchR-AB, MuSK-AB patients were more often female (p = 0.05, OR = 2.74) and classified as Myasthenia Gravis Foundation of America-class IV before crisis (p = 0.04, OR = 3.25). MuSK-AB patients suffer more often from multiple chronic disease (p = 0.016, OR = 4.87) and were treated more invasively in terms of plasma exchanging therapies (not significant). The number of days of mechanical ventilation (MV) (43.0 ± 53.1 vs. 17.4 ± 18; p < 0.0001), days on an intensive care unit (ICU) (45.3 ± 49.5 vs. 21.2 ± 19.7; p < 0.0001), and hospital-length of stay (LOS) (55.9 ± 47.6 vs. 28.8 ± 20.9 days; p < 0.0001) were significantly increased in MuSK-MC. Remarkable is that these changes were mainly due to patients with MusK-ABs only, whereas patients' outcome with both antibodies was similar to AchR-MCs. Furthermore, our data showed a shortened duration of MV after treatment with plasma exchanging therapies compared to treatment with intravenous immunoglobulin in MuSK-MCs. We conclude that MuSK-AB-status is associated with a longer need of MV, ICU-LOS, and hospital-LOS in MC, and therefore recommend early initiation of a disease-specific therapy.
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