Tsonis, A.I. (56656278100)A.I. (56656278100)TsonisZisimopoulou, P. (24376998400)P. (24376998400)ZisimopoulouLazaridis, K. (56603256800)K. (56603256800)LazaridisTzartos, J. (23483327100)J. (23483327100)TzartosMatsigkou, E. (55978921600)E. (55978921600)MatsigkouZouvelou, V. (8535619100)V. (8535619100)ZouvelouMantegazza, R. (7007022015)R. (7007022015)MantegazzaAntozzi, C. (7003634542)C. (7003634542)AntozziAndreetta, F. (6701660100)F. (6701660100)AndreettaEvoli, A. (7003290058)A. (7003290058)EvoliDeymeer, F. (6603952751)F. (6603952751)DeymeerSaruhan-Direskeneli, G. (55405118500)G. (55405118500)Saruhan-DireskeneliDurmus, H. (26767720100)H. (26767720100)DurmusBrenner, T. (7004884189)T. (7004884189)BrennerVaknin, A. (36572839600)A. (36572839600)VakninBerrih-Aknin, S. (7004839194)S. (7004839194)Berrih-AkninBehin, A. (24072944800)A. (24072944800)BehinSharshar, T. (7004157942)T. (7004157942)SharsharDe Baets, M. (14624885100)M. (14624885100)De BaetsLosen, M. (6507635956)M. (6507635956)LosenMartinez-Martinez, P. (8951108100)P. (8951108100)Martinez-MartinezKleopa, K.A. (6603667270)K.A. (6603667270)KleopaZamba-Papanicolaou, E. (6506279307)E. (6506279307)Zamba-PapanicolaouKyriakides, T. (7006056265)T. (7006056265)KyriakidesKostera-Pruszczyk, A. (20235055500)A. (20235055500)Kostera-PruszczykSzczudlik, P. (16308272100)P. (16308272100)SzczudlikSzyluk, B. (6505763786)B. (6505763786)SzylukLavrnic, D. (6602473221)D. (6602473221)LavrnicBasta, I. (8274374200)I. (8274374200)BastaPeric, S. (35750481700)S. (35750481700)PericTallaksen, C. (6701619496)C. (6701619496)TallaksenManiaol, A. (36053344700)A. (36053344700)ManiaolCasasnovas Pons, C. (55995300800)C. (55995300800)Casasnovas PonsPitha, J. (23006350900)J. (23006350900)PithaJakubíkova, M. (48361571900)M. (48361571900)JakubíkovaHanisch, F. (7005111902)F. (7005111902)HanischTzartos, S.J. (7007126407)S.J. (7007126407)Tzartos2025-06-122025-06-122015https://doi.org/10.1016/j.jneuroim.2015.04.015https://www.scopus.com/inward/record.uri?eid=2-s2.0-84929849327&doi=10.1016%2fj.jneuroim.2015.04.015&partnerID=40&md5=4a7b9f4b94f3acc277084f433acb1db6https://remedy.med.bg.ac.rs/handle/123456789/8205Seronegative myasthenia gravis (MG) presents a serious gap in MG diagnosis and understanding. We applied a cell based assay (CBA) for the detection of muscle specific kinase (MuSK) antibodies undetectable by radioimmunoassay. We tested 633 triple-seronegative MG patients' sera from 13 countries, detecting 13% as positive. MuSK antibodies were found, at significantly lower frequencies, in 1.9% of healthy controls and 5.1% of other neuroimmune disease patients, including multiple sclerosis and neuromyelitis optica. The clinical data of the newly diagnosed MuSK-MG patients are presented. 27% of ocular seronegative patients were MuSK antibody positive. Moreover, 23% had thymic hyperplasia suggesting that thymic abnormalities are more common than believed. © 2015 Elsevier B.V.AutoantibodiesCell based assayDiagnosisMuSKMyasthenia gravis