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Acetylcholine Receptor Antibody Positivity, RNST Abnormality, and Thymoma Predict Generalization in Ocular Myasthenia Gravis: A South Korean Cohort Study.

Overview

Authors: Hyun Jin Shin1,2,3, Chaerin Kwon1, Jeeyoung Oh1,3,4
  1. School of Medicine, Konkuk University, Chungju-si 27478, Republic of Korea; (H.J.S.); (C.K.)
  2. Department of Ophthalmology, Konkuk University Medical Center, Seoul 05030, Republic of Korea
  3. Research Institute of Medical Science, Konkuk University, Seoul 05029, Republic of Korea
  4. Department of Neurology, Konkuk University Medical Center, Seoul 05030, Republic of Korea
Institutions: Konkuk University (South Korea); Konkuk University Medical Center (South Korea)
Journal: Antibodies (Basel, Switzerland), volume 15, issue 4, article 73
Dates: received 17 June 2026; accepted 7 August 2026; published online 11 August 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.3390/antib15040073 · PMID 42645431 · PMCID PMC13509972 · OpenAlex W7202204029
Open access: gold, a free copy (OpenAlex)
Status: data only
Categories: human (organism), other condition (population), cellular / molecular (subfield)
Methods: Statistics, Physiology & signal measures
Keywords: ocular myasthenia gravis, generalized myasthenia gravis, acetylcholine receptor antibody, repetitive nerve stimulation test, thymoma
Topic: Myasthenia Gravis and Thymoma (Neurology, Medicine), according to OpenAlex
Funding: National Research Foundation of Korea (RS-2026-25489895); Korean Government (MSIT) (RS-2026-25489895)
Citations: not cited yet (Europe PMC); 33 references in the paper

Abstract

Background: Ocular myasthenia gravis (OMG) can remain restricted to ocular symptoms or progress to generalized myasthenia gravis (GMG). However, the rate of generalization and its predictors may vary across populations, and data on South Korean patients remain inadequate. This study investigated the conversion rate from OMG to GMG and identified clinical, serologic, electrophysiologic, and thymic predictors of this generalization in a South Korean cohort. Methods: This retrospective cohort study included 89 patients who initially presented with OMG and were followed up for at least 2 years. The primary outcome was conversion to GMG during follow-up. The investigated predictors included demographic variables, initial ocular manifestations, acetylcholine receptor antibody (AChR-Ab) status and titer, repetitive nerve stimulation test (RNST) findings, thymic abnormalities, and immunosuppressive treatment. Kaplan–Meier analyses and Cox proportional-hazards models were used to evaluate the GMG-free survival rate and risk factors for conversion. Results: During follow-up, 10 patients (11.2%) progressed to GMG, with this conversion occurring within 2 years in 8 patients (9.0%). All converters were AChR-Ab positive. AChR-Ab positivity, RNST positivity, thymic abnormality, and thymoma were associated with GMG conversion in univariable analyses. RNST positivity in any tested muscle (hazard ratio [HR] = 12.66, 95% confidence interval [CI] = 2.68–59.76, p = 0.001) and thymoma (HR = 10.67, 95% CI = 3.06–37.27, p < 0.001) was associated with generalization. These associations persisted in the restricted multivariable Cox model. Conclusions: The rate of GMG conversion was relatively low in this South Korean OMG cohort, and most conversions occurred within 2 years. The presence of AChR-Ab positivity, RNST abnormality, or thymoma may characterize high-risk patients who require closer monitoring during the early disease course.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Data

Datasets cited

Data Availability Statement

The minimal anonymized dataset required to reproduce the findings of our study has been deposited in a public repository (Figshare) and is accessible via the following DOI: http://doi.org/10.6084/m9.figshare.32573280.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

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Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 3 authors, 5 keywords, 2 funders, 33 references.

Cite

This paper

Shin, H. J., Kwon, C., & Oh, J. (2026). Acetylcholine Receptor Antibody Positivity, RNST Abnormality, and Thymoma Predict Generalization in Ocular Myasthenia Gravis: A South Korean Cohort Study. Antibodies (Basel, Switzerland), 15(4), 73. https://doi.org/10.3390/antib15040073

BibTeX

@article{shin2026acetylcholine,
author = {Shin, Hyun Jin and Kwon, Chaerin and Oh, Jeeyoung},
title = {{Acetylcholine Receptor Antibody Positivity, RNST Abnormality, and Thymoma Predict Generalization in Ocular Myasthenia Gravis: A South Korean Cohort Study}},
journal = {Antibodies (Basel, Switzerland)},
year = {2026},
month = aug,
volume = {15},
number = {4},
pages = {73},
publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},
issn = {2073-4468},
doi = {10.3390/antib15040073},
url = {https://doi.org/10.3390/antib15040073},
pmid = {42645431},
pmcid = {PMC13509972}
}

RIS

TY - JOUR
AU - Shin, Hyun Jin
AU - Kwon, Chaerin
AU - Oh, Jeeyoung
TI - Acetylcholine Receptor Antibody Positivity, RNST Abnormality, and Thymoma Predict Generalization in Ocular Myasthenia Gravis: A South Korean Cohort Study
T2 - Antibodies (Basel, Switzerland)
J2 - Antibodies (Basel)
PY - 2026
DA - 2026/08/11
VL - 15
IS - 4
SP - 73
SN - 2073-4468
PB - Multidisciplinary Digital Publishing Institute (MDPI)
DO - 10.3390/antib15040073
UR - https://doi.org/10.3390/antib15040073
LA - en
ER -

CSL-JSON

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