Diagnostic value of antibody concentration ratio for treatment-refractory myasthenia gravis.

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY

Neurological Sciences Pub Date : 2024-10-01 Epub Date: 2024-05-23 DOI:10.1007/s10072-024-07601-w

Yi Li, Shumei Yang, Xiaohua Dong, Weiwei Duan, Fei Jiang, Kangzhi Chen, Qian Zhou, Haobin Cai, Huan Yang

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Abstract

Objective: This study aimed to assess the diagnostic potential of the Antibody concentration ratio in identifying treatment-refractory myasthenia gravis (MG).

Methods: A retrospective analysis was conducted on 116 MG patients who underwent antibody detection at least twice between June 1, 2015, and June 1, 2023. Demographic and clinical characteristics were collated to ascertain their association with refractory MG. The Antibody Concentration Ratio was applied to determine treatment response, using the International Consensus Guidance criteria as the reference standard. The area under nonparametric receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy were calculated to assess the diagnostic efficacy of the Antibody concentration ratio following consecutive immunotherapy relative to initial antibody concentrations for refractory MG.

Results: 19 out of 116 patients were unequivocally diagnosed with refractory MG. A significant correlation was found between the Antibody Concentration Ratio and refractory MG status in treatment-refractory and treatment-responsive patients. Subsequently, the AUC demonstrated the robust diagnostic capability of the Antibody concentration ratio for refractory MG, with an AUC of 0.8709 (95% CI: 0.7995-0.9422, p < 0.0001). The optimal cut-off value stood at 0.8903, exhibiting a sensitivity of 94.74% (95% CI: 75.36%-99.73%), a specificity of 68.04% (95% CI: 58.23%-76.48%), and accuracy of 72.41% (95% CI: 64.28%-80.54%).

Conclusion: Elevated Antibody Concentration Ratio is intrinsically linked with refractory MG and exhibits potential as an diagnostic biomarker for the condition.

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抗体浓度比值对难治性肌无力的诊断价值。

研究目的本研究旨在评估抗体浓度比值在识别难治性肌无力（MG）方面的诊断潜力：对2015年6月1日至2023年6月1日期间至少接受过两次抗体检测的116名MG患者进行了回顾性分析。整理了人口统计学和临床特征，以确定其与难治性 MG 的关联。以国际共识指导标准为参考标准，采用抗体浓度比来确定治疗反应。计算了非参数接收器操作特征曲线下面积（AUC）、灵敏度、特异性和准确性，以评估连续免疫疗法后抗体浓度比值相对于难治性 MG 初始抗体浓度的诊断效果：结果：116 例患者中有 19 例被明确诊断为难治性 MG。在难治性和治疗应答患者中，抗体浓度比值与难治性 MG 状态之间存在明显相关性。AUC值为0.8709（95% CI：0.7995-0.9422，p）：抗体浓度比值升高与难治性 MG 有内在联系，具有作为该疾病诊断生物标记物的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurological Sciences 医学-临床神经学

CiteScore

6.10

自引率

3.00%

发文量

743

审稿时长

4 months

期刊介绍： Neurological Sciences is intended to provide a medium for the communication of results and ideas in the field of neuroscience. The journal welcomes contributions in both the basic and clinical aspects of the neurosciences. The official language of the journal is English. Reports are published in the form of original articles, short communications, editorials, reviews and letters to the editor. Original articles present the results of experimental or clinical studies in the neurosciences, while short communications are succinct reports permitting the rapid publication of novel results. Original contributions may be submitted for the special sections History of Neurology, Health Care and Neurological Digressions - a forum for cultural topics related to the neurosciences. The journal also publishes correspondence book reviews, meeting reports and announcements.