Annals of Indian Academy of Neurology
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Year : 2021  |  Volume : 24  |  Issue : 2  |  Page : 293-294

Authors' reply

Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

Date of Submission29-Apr-2020
Date of Acceptance22-Jul-2020
Date of Web Publication07-Oct-2020

Correspondence Address:
Vinay Goyal
Director Neurology, Room No 6, Neurosciences Institute, Medanta The Medicity Gurugram, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aian.AIAN_364_20

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How to cite this article:
Samal P, Goyal V. Authors' reply. Ann Indian Acad Neurol 2021;24:293-4

How to cite this URL:
Samal P, Goyal V. Authors' reply. Ann Indian Acad Neurol [serial online] 2021 [cited 2021 Jun 23];24:293-4. Available from:

Dear Sir,

We thank author for their interest in our study.[1]

Our study compared 23 patients with muscle-specific tyrosine kinase (MuSK)-positive myasthenia (MuSK+ve MG) with 55 patients with acetylcholine receptor positive myasthenia (AChR+ve MG) and nine patients with double-seronegative myasthenia (DN-MG) and did not find any significant difference in terms of clinical characteristics, treatment response to immunosuppressants, long-term prognosis, and quality of life.[2]

The utility of antibodies for establishing the diagnosis of myasthenia is well established.

To the best of our knowledge, our study describes the clinical features of the fourth largest cohort of MuSK+ve MG from a single center. Also, it is the only study apart from Deymeer et al.[3] where a comparison is made with AChR+ve MG group and DN-MG group. We agree with author that it is still a small and ambispective study and the conclusion needs confirmation with a larger prospective cohort.[1] Until then, our study gives a different point of view viz. prognosis in MuSK+ve MG is not always grave. This is not a novel revelation. Guptill et al. in their description of the largest multicentric cohort of MuSK + ve MG patients (n = 110) also state that the long-term prognosis is favorable and comparable to AChR+ve MG patients.[4]

It is a well-known fact that there is no role of thymectomy in patients with MUSK+ve MG, so question does not arise about our discussion about thymectomy (only three MuSK+ve MG patients in our series underwent thymectomy—one had thymoma and other two were operated before 2000, i.e., prior to antibody testing). So, it is irrelevant to comment that we have not done an adequate literature search on this matter.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Renjen PN. Subgroup classification of myasthenia gravis. Ann Indian Acad Neurol 2020;[In press].  Back to cited text no. 1
Samal P, Goyal V, Singh MB, Padma Srivastava MV. MuSK (Muscle Specific Kinase) positive myasthenia: Grave prognosis or undue prejudice?. Ann Indian Acad Neurol 2020;23:32-7.  Back to cited text no. 2
  [Full text]  
Deymeer F, Gungor-Tuncer O, Yilmaz V, Parman Y, Serdaroglu P, Ozdemir C, et al. Clinical comparison of anti-MuSK- vs anti-AChR-positive and seronegative myasthenia gravis. Neurology 2007;68:609-11.  Back to cited text no. 3
Guptill JT, Sanders DB, Evoli A. Anti-MuSK antibody myasthenia gravis: Clinical findings and response to treatment in two large cohorts. Muscle Nerve 2011;44:36-40.  Back to cited text no. 4


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