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Deficiencies in anti-acetylcholine receptor antibody measurement in myasthenia gravis.
  1. C E Clarke,
  2. D I Shepherd,
  3. G M Yuill,
  4. J C Smaje,
  5. P B Wilson
  1. Department of Neurology, North Manchester General Hospital, UK.


    In a retrospective case note study of 86 patients with myasthenia gravis, 60 had an anti-acetylcholine receptor antibody assay performed by the regional immunology laboratory. Antibody was detected in 38% which compares with 66-93% in other series. Whilst the use of staphylococcal protein A to precipitate the antibody-receptor complex, rather than anti-human immunoglobulin, may be partly responsible for this low sensitivity, other methodological problems are likely to exist. It is suggested that this potentially critical assay becomes a subject for regular audit.

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