Abstract
The authors investigated in a group of 104 patients with myasthenia gravis (MG) the frequency of HLA antigens class I and II in relation to different clinical variants of the disease. During the overall evaluation in patients with MG, consistent with the literature, a significantly higher incidence of the most common HLA haplotype of the caucasian population HLA -A1, B8, DR3, DQ2 was found.
Its frequency was elevated in particular in patients with antibodies against the acetylcholine receptor (ACHR), with generalized affection, with an unstable clinical course, in patients without a thymoma and younger than 60 years. On the other hand, in patients with a thymoma the frequency of HLA B8 and -DR3 was significantly reduced and conversely the frequency of HLA -DR8 was significantly elevated.
In younger patients (under 60 years) there was a statistically significantly higher frequency of HLA -DR3 and -DQ2 signs. In seropositive patients (with evidence of antibodies against ACHR) there was a significantly raised frequency of -DQ1 and DQ3.
In the generalized and clinically unstable form of the disease there was a significantly elevated frequency of HLA -B8, while in ocular forms of MG, in patients with a tendency of spontaneous remission and patients lacking antibodies against ACHR the frequency of HLA -B8 was comparable with the incidence in the healthy population. From the above findings it is apparent that assessment of HLA antigens in patients with MG could be used for partial prediction of the development of the disease and for assessment of the optimal therapeutic strategy.