Page 236 - Read Online

Delgado-García et al. Neuroimmunol Neuroinflammation 2017;4:236-7 Neuroimmunology and
DOI: 10.20517/2347-8659.2017.39
Neuroinflammation

www.nnjournal.net
Letter to Editor Open Access

Peripheral plasmablasts in anti-MuSK

myasthenia gravis

Guillermo Delgado-García, Teresa Corona-Vázquez

Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and Neurosurgery, Mexico City 14269, Mexico.
Correspondence to: Prof. Teresa Corona-Vázquez, Clinical Laboratory of Neurodegenerative Diseases, National Institute of Neurology and
Neurosurgery, Insurgentes Sur #3877, Col. La Fama, Del. Tlalpan, Mexico City 14269, Mexico. E-mail: coronav@unam.mx
How to cite this article: Delgado-García G, Corona-Vázquez T. Peripheral plasmablasts in anti-MuSK myasthenia gravis. Neuroimmunol
Neuroinflammation 2017;4:236-7.

Article history: Received: 4 Aug 2017 Accepted: 25 Aug 2017 Published: 9 Nov 2017

[1]
As Hong and Sung previously did, we read with great and an abnormal one (patients). Finally, vaccination
[2]
interest the study published by Guptill et al. They history in controls is also an important point to
reported that anti-muscle-specific kinase (MuSK) consider, since it has been documented that peripheral
myasthenia gravis patients and healthy controls had plasmablasts increase after vaccination .
[5]
similar percentages of peripheral plasmablasts. This
result is derived from a comparison between 13 Increased peripheral plasmablasts have been found
female patients (out of the 18 originally included in in various immune-based diseases. IgG4-related
[2]
[6]
the study) and 6 controls . Taking into account the disease is one of these conditions . In connection
[3]
[7]
effect of rituximab on peripheral plasmablasts , those with the above, Raibagkar et al. recently reported
patients treated with it (n = 3) were not included in the case of a 54-year-old woman with anti-MuSK
the previous comparison. Excluding these patients, myasthenia gravis who also developed retroperitoneal
6 (40%) were on chronic prednisone treatment, lymphadenopathy histopathologically consistent with
whose dose was between 2.5 mg every other day IgG4-related disease. They did not report the count of
and 20 mg daily. However, it is already known that peripheral plasmablasts in this patient. We conducted
prednisone therapy effectively decreases peripheral a search in PubMed and found an additional case of
[4]
plasmablasts , so this could contribute to the lack a 72-year-old man with myasthenia gravis who also
of difference between patients and controls. They developed an inflammatory aortic aneurysm. The latter
also reported that immunosuppressed (n = 7) and was compatible with a possible diagnosis of IgG4-
non-immunosuppressed (n = 6) patients had similar related disease. Nevertheless, the antibody involved in
percentages of peripheral plasmablasts. A comparison the diagnosis of myasthenia gravis in this patient is not
[8]
between non-immunosuppressed patients and reported .
controls would have also been quite informative, since
[7]
it would eliminate the prednisone factor and facilitate In the title of their short communication, Raibagkar et al.
the demonstration of a difference between a seemingly wonder if there is any relationship between the two
normal population of peripheral plasmablasts (controls) diseases. It is interesting to note that in anti-MuSK

Quick Response Code:
This is an open access article licensed under the terms of Creative Commons Attribution 4.0 International
License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution,
and reproduction in any medium, as long as the original author is credited and the new creations are licensed under the
identical terms.
For reprints contact: service@oaepublish.com

236 © The author(s) 2017 www.oaepublish.com