Autoimmune Myasthenia Gravis

Abstract

Objective: This article reviews the diagnosis and management of autoimmune myasthenia gravis (MG), encompassing epidemiology, clinical features including disease heterogeneity, pathophysiology, and therapeutic approaches.

Latest developments: Recent advances in MG pathophysiology and clinical outcome measures have catalyzed the development of novel therapies, including complement and neonatal Fc receptor inhibitors, which target specific components of the autoimmune attack on the muscle endplate.

Essential points: Patients with MG exhibit fluctuating muscle weakness. Diagnosis is confirmed by acetylcholine receptor or muscle-specific kinase (MuSK) antibodies, electrodiagnostic testing, or both. Management involves tailored combinations of therapies based on patient and MG-specific factors. The treatment of patients with MG with exclusively ocular weakness, thymoma, child-bearing potential, myasthenic crisis, or MG related to cancer immunotherapy has unique considerations. Prompt diagnosis and treatment are crucial to restore neuromuscular function and minimize treatment-related complications.