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MG antibodies
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MG antibodies

In an acetylcholine antibody test, is it possible to test positive for blocking antibodies, when the results are negative for binding and modulating antibodies?
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Acetylcholine receptor antibodies are present in myasthenia gravis, which is an autoimmune disorder in which the neuromuscular transmission is affected, and manifests with weakness and fatigability.
As you are asking, there are different autoantibodies affecting the neuromuscular junction. Binding, blocking and modulating antibodies have different actions in the neuromuscular junction and target different proteins. Not all patients with myasthenia gravis will have the antibodies positive, and certainly one patient can have a positive result in one type of the antibodies with a negative result in one of the others.
A study of these antibodies showed that Binding antibodies are positive in about 86% of the cases, modulating also in about 86%, and blocking in up to 52%. Also between 76 to 93% of adults with MG will have one of the antibodies positive. The fact that one is positive does not mean that the others are going to be positive as well.
I hope this information is useful, and that you discuss this in an appropriate way with your physician, as these antibodies may be sometimes difficult to interpret, and results should be addressed in the setting of the clinical presentation, symptoms, history and neurologic exam.
Good luck.
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