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Facts About Anti-MuSK Antibody-Positive Generalized Myasthenia Gravis: Symptoms, Treatments, and More

Written by Emily Wagner, M.S.
Posted on September 25, 2024

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In people with generalized myasthenia gravis (gMG), the immune system makes harmful proteins called autoantibodies. These autoantibodies impair the function of the nerves that control muscles.1,2 There are different types of autoantibodies in myasthenia gravis.2 When you’re diagnosed with gMG, your doctor may test your blood to find out which autoantibodies you may have. About 7 percent to 10 percent of people with MG have anti-muscle-specific kinase (MuSK) antibodies.2

If you or a loved one has anti-MuSK antibody-positive gMG, it’s important to learn more about your condition and what to expect.

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Symptoms of Anti-MuSK Antibody-Positive Generalized Myasthenia Gravis

People with anti-MuSK antibody-positive gMG may have certain patterns of symptoms.2,3 This pattern may change which symptoms you’re more likely to have or when they start.

Eye Symptoms

Anti-MuSK antibody-positive gMG often affects the eyes first.3 Many people have eye symptoms such as drooping eyelids or double vision when they first visit their doctor.3 A large cohort study reviewed symptoms in 110 people with anti-MuSK antibody-positive MG.4 Results showed that 36 percent had only eye symptoms at onset.4 ​​

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A large cohort study reviewed symptoms in 110 people with anti-MuSK antibody-positive MG.4 Results showed that 36 percent had only eye symptoms at onset.4

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Neck and Jaw Weakness

​Many people with anti-MuSK antibody-positive gMG experience weakness in the muscles of the neck and jaw.2 Neck and jaw weakness may lead to3,5:

  • Trouble chewing or swallowing
  • Choking while eating
  • Difficulty talking
  • Nasal or slurred speech
  • Problems holding your head up

In one small retrospective review of 21 people with anti-MuSK antibody-positive MG, 42.9 percent had onset of symptoms in the neck and jaw area.6 ​​​​​

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Progression of Anti-MuSK Antibody-Positive Generalized Myasthenia Gravis​​​​​​

Anti-MuSK antibody-positive gMG tends to start at an earlier age than other types of generalized myasthenia gravis.2 Most people notice symptoms in their late 20s.3​​​​​

People with anti-MuSK antibody-positive gMG who first develop eye symptoms often progress to generalized myasthenia gravis.5 With gMG, you have muscle weakness in your arms, hands, and legs.5 In a retrospective review of 10 people who first had eye symptoms of anti-MuSK antibody-positive MG, the mean progression time to generalized weakness was about four months.6 ​​​​​​

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Treating Anti-MuSK Antibody-Positive Generalized Myasthenia Gravis

Your health care provider can help you understand your treatment options for anti-MuSK antibody-positive gMG and how they work.

Myasthenic Crisis With Anti-MuSK Antibody-Positive gMG

A myasthenic crisis is when the muscles in your chest become too weak to help you breathe.7 This can be fatal if it’s not treated right away.7 ​​​​​

Triggers for a myasthenic crisis can include8:

  • Stress
  • Infections
  • Surgery
  • Sudden changes in medication

If you are feeling short of breath, it’s very important to call 911 or get medical help immediately.9

Immunosuppressive Treatment for Anti-MuSK Antibody-Positive gMG

Immunosuppressants can treat myasthenia gravis in some people, but they may not keep working in the long term.3 Immunosuppressants may not work well for 10 percent to 15 percent of people with anti-MuSK antibody-positive MG.3

Targeted Treatment

Researchers are developing targeted treatment strategies aimed at different types of generalized myasthenia gravis.2

Common Myasthenia Gravis Treatment May Not Work for Anti-MuSK Antibody-Positive gMG

People with anti-MuSK antibody-positive MG may not respond to acetylcholinesterase inhibitors, a standard gMG treatment.3

For more details about your treatment options, talk to your MG specialist.

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Talk With Others Who Understand

MGteam is the social network for people with myasthenia gravis and their loved ones. On MGteam, members come together to ask questions, give advice, and share their stories with others who understand life with MG.

Are you living with anti-MuSK antibody-positive myasthenia gravis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

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©️2024 UCB, Inc., Smyrna, GA 30080. All rights reserved.
US-DA-2400250 Date of Preparation: September 2024

References
  1. Ma H, Murphy C, Loscher CE, O’Kennedy R. Autoantibodies — enemies, and/or potential allies? Front Immunol. 2022;13:953726. doi:10.3389/fimmu.2022.953726
  2. Dresser L, Wlodarski R, Rezania K, Soliven B. Myasthenia gravis: epidemiology, pathophysiology and clinical manifestations. J Clin Med. 2021;10(11):2235. doi:10.3390/jcm10112235
  3. Rodolico C, Bonanno C, Toscano A, Vita G. MuSK-associated myasthenia gravis: clinical features and management. Front Neurol. 2020;11:660. doi:10.3389/fneur.2020.00660
  4. Guptill JT, Sanders DB, Evoli A. Anti-musk antibody myasthenia gravis: clinical findings and response to treatment in two large cohorts. Muscle Nerve. 2011;44(1):36-40. doi:10.1002/mus.22006
  5. Myasthenia gravis (MG): signs and symptoms. Muscular Dystrophy Association. Accessed January 9, 2024. https://www.mda.org/disease/myasthenia-gravis/signs-and-symptoms
  6. Huang Q, Li Feng, Zhao S. Spotlight on MuSK positive myasthenia gravis: clinical characteristics, treatment and outcomes. BMC Neurol. 2022;22(1):73. doi:10.1186/s12883-022-02593-6
  7. Xin H, Harris LA, Aban IB, Cutter G. Examining the impact of refractory myasthenia gravis on healthcare resource utilization in the United States: analysis of a Myasthenia Gravis Foundation of America patient registry sample. J Clin Neurol. 2019;15(3):376-385. doi:10.3988/jcn.2019.15.3.376
  8. Myasthenia gravis. NORD. Updated January 10, 2022. Accessed January 9, 2024. https://rarediseases.org/rare-diseases/myasthenia-gravis
  9. MG emergencies. Myasthenia Gravis Foundation of America. Accessed January 9, 2024. https://myasthenia.org/MG-Community/-MG-Emergencies

Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here.
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