Clinical characteristics and HLA-B, HLA-DRB1 genotypes of patients with myasthenia gravis

Pham Kieu Anh Tho, Le Dinh Tung, Pham Van Phuong, Tran Van De, Nguyen Thanh Binh

Main Article Content

Abstract

 Myasthenia gravis is a rare autoimmune disorder. Previous studies have reported that the disease
is associated with HLA genes, especially the HLA-B and HLA-DRB1 loci. This cross-sectional study
described the characteristics and genotypes of 15 patients with myasthenia gravis from 01/2020 to
10/2020. There were 9 (60%) female and 6 (40%) male patients, and the average age of the patients
was 46 ± 9.6 years old. About half (53.3%) were diagnosed in mild grade (group I and group II); 46.7%
were diagnosed in severe grade (group III and group IV); and 60% had positive acetylcholine receptors
antibodies. The HLA-B locus has 14 alleles, of which the most common alleles were -B*15 (26.6%),
-B*40 (10%), -B*18 (10%), and -B*46 (10%); and HLA-DRB1 locus has 11 alleles of which the most
common alleles were HLA-DRB1*09 (26.6%), -DRB1*12 (20%), -DRB1*14 (10%), and -DRB1*04 (10%).

Article Details

References

1. Hehir MK, Silvestri NJ. Generalized Myasthenia Gravis: Classification, Clinical Presentation, Natural History, and Epidemiology. Neurologic Clinics. 2018;36(2):253-260.
2. Vander Heiden JA, Stathopoulos P, Zhou JQ, et al. Dysregulation of B Cell Repertoire Formation in Myasthenia Gravis Patients Revealed through Deep Sequencing. J Immunol. 2017;198(4):1460-1473.
3. Gregersen PK, Kosoy R, Lee AT, et al. Risk for myasthenia gravis maps to a (151) Pro-->Ala change in TNIP1 and to human leukocyte antigen-B*08. Ann Neurol. 2012;72(6):927-935.
4. Xie Y-c, Qu Y, Sun L, et al. Association between HLA-DRB1 and myasthenia gravis in a northern Han Chinese population. Journal of Clinical Neuroscience. 2011;18(11):1524-1527.
5. Nishino M, Ashiku SK, Kocher ON, Thurer RL, Boiselle PM, Hatabu H. The thymus: a comprehensive review. Radiographics. 2006; 26(2):335-348.
6. Philippe Gajdos MCT, MD. Treatment of Myasthenia Gravis Exacerbation with Intravenous Immunoglobulin. Arch Neurol. 2005;62:1689-1693.
7. Nils Erik Gilhus ST. Myasthenia gravis. Disease Primer. 2019;5:30.
8. Phillips LH. The Epidemiology of Myasthenia Gravis. Seminars in Neurology. 2004;24(1):17-20.
9. Soltys J, Gong B, Kaminski HJ, Zhou Y, Kusner LL. Extraocular muscle susceptibility to myasthenia gravis: unique immunological environment?. Ann N Y Acad Sci. 2008;1132:220-224.
10. T.H. Popperud MIB, M. Rasmussen, E. Kerty. Juvenile myasthenia gravis in Norway: Clinical characteristics, treatment, and long-term outcome in a nationwide population-based cohort. Official Journal of the European Paediatric Neurology Society. 2017;21:707-714.
11. Compston DA, Vincent A, Newsom-Davis J, Batchelor JR. Clinical, pathological, HLA antigen and immunological evidence for disease heterogeneity in myasthenia gravis. Brain. 1980;103(3):579-601.
12. Fernández-Mestre MT, Vargas V, Montagnani S, Cotúa M, Ogando V, Layrisse Z. HLA Class II and class I polymorphism in venezuelan patients with myasthenia gravis. Human Immunology. 2004;65(1):54-59.
13. Hoa BK, Hang NT, Kashiwase K, et al. HLA-A, -B, -C, -DRB1 and -DQB1 alleles and haplotypes in the Kinh population in Vietnam. Tissue Antigens. 2008;71(2):127-134.
14. Yoshida T, Tsuchiya M, Ono A, Yoshimatsu H, Satoyoshi E, Tsuji K. HLA antigens and myasthenia gravis in Japan. J Neurol Sci. 1977;32(2):195-201.
15. Santos E, Bettencourt A, da Silva AM, et al. HLA and age of onset in myasthenia gravis. Neuromuscular Disorders. 2017;27(7):650-654.