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To the Editor:
We read the article by Lauriola et al.1 with great interest. The investigators studied thymic morphological changes in 12 anti-acetylcholine receptor antibodies (AChR)-negative and anti-muscle specific receptor tyrosine kinase antibodies (MuSK)-positive, in 20 AChR- and MuSK-negative, and in 30 AChR-positive patients. They found no or minimal abnormalities in MuSK-positive patients, whereas hyperplastic changes were seen in 35% of MuSK- and AChR-negative patients and in 67% of the AChR-positive cases. The authors suggest that there is no role of intrathymic disease in MuSK-positive MG pathogenesis.
We have a 30-year-old female patient with seronegative thymomatous MG with positive MuSK antibodies. In October 2001, she had diplopia, ptosis, and dysphagia. She responded well to pyridostigmine and prednisolone combination, and underwent a thymectomy. Thymic histology disclosed a …
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