Myasthenia Gravis Panel II

Test ID: 

705225

CPT code:

86255, 83519

Clinical Use:

Diagnose acquired myasthenia gravis1

Test Information:

Myasthenia gravis is an acquired disorder of neuromuscular transmission characterized by use-associated muscle weakness and fatigability. This condition frequently involves the extraocular muscles and has a strong association with tumor of the thymus (thymoma). The disease has a prevalence of approximately 5 per 100,000 individuals and can occur at any age. In women, the disease usually presents between the ages of 20 and 40 years, while disease onset in men typically occurs later in life.

Autoantibodies to postsynaptic acetylcholine receptors are detectable in the serum of 90% of patients with generalized myasthenia gravis and approximately 70% of patients with ocular myasthenia. These autoantibodies interfere with normal neuromuscular function, causing muscle weakness and fatigue. Antibody titers tend to be higher in females and a correlation between antibody titer and degree of muscle weakness has been observed in individual patients. Receptor antibody titers tend to rise several weeks before exacerbations in patients with established myasthenia gravis. Remission after thymectomy is associated with a progressive decline in antibody titers. Consequently, serial measurements of acetylcholine receptor antibodies can be useful in monitoring disease progression as well as the effects of treatment.

Myasthenia gravis is often associated with striational antibody. AChR binding antibodies can also be positive in uncomplicated thymoma, Lambert-Eaton myasthenic syndrome, primary lung cancer and in patients with autoimmune liver disease.

Striational antibodies are found in approximately 30% of patients with acquired myasthenia gravis. The rate of positivity increases with age of onset and 55% of individuals with disease onset after age 60 will have striational antibodies.These antibodies can be positive in myasthenia gravis patients in the absence of AChR antibodies.

Specimen Type:

Serum

Requested Volume: 

2 mL

Minimum Volume: 

1 mL

Container Type: 

Red-top tube or gel-barrier tube

Collection:

If a red-top tube is used, transfer separated serum to a plastic transport tube.

Storage Instructions:

Refrigerate

Stability Requirements:

Temperature

Period

Room temperature

14 days

Refrigerated

14 days

Frozen

14 days

Freeze/thaw cycles

Stable x3

Rejection Criteria:

Excessive hemolysis; chylous serum; recently administered isotopes; plasma specimen.

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