Improving sensitivity of autoantibody testing for myasthenia gravis using cell-based assays: an evaluation of strategies that may be used in clinical practice - Summary - MDSpire
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Improving sensitivity of autoantibody testing for myasthenia gravis using cell-based assays: an evaluation of strategies that may be used in clinical practice
To evaluate strategies to improve sensitivity of autoantibody testing for myasthenia gravis (MG) using cell-based assays (CBAs).
Approach:
Quality Improvement Evaluation: A QI/QA evaluation of patients at London Health Sciences Centre/St. Joseph’s Health Care London who underwent anti-AChR/MuSK fixed CBA testing from January 2023–January 2026.
Key Findings:
During the 3-year evaluation period, 973 patients underwent anti-AChR/MuSK fixed CBA at routine 1:10 dilution. Out of these, 127 (13.1%) were autoantibody positive.
Repeat fixed CBA identified positivity in 4 out of 78 (5%) initially negative patients.
Send-out live CBA detected positivity in 4 out of 13 (31%) patients with negative/indeterminable results from fixed CBA.
Fixed CBA at a lower dilution (1:5) revealed positivity in 4 out of 8 (50%) samples that were negative at 1:10 dilution.
Interpretation:
Repeat fixed CBA, send-out live CBA, and lower dilution fixed CBA may enhance sensitivity in detecting autoantibodies for MG.
Limitations:
The study is limited to a single center's evaluation.
The findings may not be generalizable to other settings.
Conclusion:
The strategies evaluated may improve sensitivity of autoantibody testing for MG.
