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Effect of thymectomy and immunosuppressive therapy on anti‐neuroblastoma antibody levels in patients with myasthenia gravis

Antibodies reacting with human neuroblastoma cells (NBL) are distinct from the “classical” anti‐acetylcholine receptor (AChR) antibodies in myasthenia gravis (MG). The influence of therapeutic interventions on serum anti‐NBL antibody levels was followed in 42 MG patients. Thymectomy alone was performed in 28 patients while immunosuppressive medication was given to 14 patients out of whom 10 also had a thymectomy. In most patients serum anti‐NBL antibody titers declined after thymectomy and/or during immunosuppressive treatment, though individual variations in the antibody response could be observed. Sequential examinations of individual patients revealed an association between the clinical severity of MG and anti‐NBL antibody levels. No correlation between the treatment‐induced changes of anti‐NBL and anti‐acetylcholine receptor (AChR) antibody titers could be observed during the follow‐up period in MG patients positive for both types of antibodies. These findings further emphasize the immunological complexity of MG. Anti‐NBL antibodies represent a pathogenic marker of the disease and display a regulation different from that of the anti‐AChR antibodies.