Low-density lipoprotein receptor-related protein 4

Um, so which of, um, the following diagnostic steps is the most appropriate to establish a diagnosis and guide treatment planning? So the options are, uh, do an m-- brain MRI with contrast, lumbar puncture, and neuro-ophthalmological, uh, referral.

Order MuSK antibodies and LR- LRP4 antibodies, um, plus single-fiber EMG.

Uh, repeat the AchR antibody, uh, using cell-based technology, uh, CT of the chest, and, uh, initiate empiric pyridostigmine.

Um, or do a muscle biopsy, uh, and broad genetic testing panel for congenital myasthenic syndromes.

And of course, uh, there's always the option of, of, uh, "I'm not sure." So in this particular case, um, I probably would do the MuSK antibody and LRP4 testing, um, and single-fiber EMG.

Um, the first case, um, the brain MRI with contrast, looking for perhaps brain stem lesion, um, is probably, um, not, um, the first choice because of the fluctuating nature of her condition and in addition to the fact that it's been going on, uh, fourteen months, and any lesions there would likely, um, be progressive and, um, would cause additional problems.

Um, repeating AchR antibodies, um, along with CT of the chest and initiate em- uh, empiric pyridostigmine is, uh, not an unreasonable option, and definitely the CT of the chest if you suspect, uh, MG would be, uh, the right choice because of, um, the potential for thymoma in about ten percent of the cases.

Um, at age forty-eight, uh, with symptom onset around age forty-seven, um, congenital myasthenic syndromes, uh, would be, uh, less likely, so that would not be a, a good option.

Vyvgart, also known as efgartigimod alfa f-cab, and Vyvgart Hytrulo, also known as efgartigimod alfa and hyaluronidase-qVFC, are FDA-approved prescription medicines for adults with generalized myasthenia gravis, or gMG.

This includes adults with any gMG antibody subtype, including triple seronegative, anti-acetylcholine receptor, or AchR, antibody-positive, anti-low density lipoprotein receptor-related protein 4, or LRP4, antibody positive, and anti-muscle specific tyrosine kinase, or MuSK, antibody-positive gMG.

Triple seronegative means a person does not show anti-AchR, anti-LRP4, or anti-MuSK antibodies when tested.

In this episode, you'll hear from a person living with anti-AchR antibody-positive gMG about their experiences with either Vyvgart for intravenous or IV infusion or Vyvgart Hytrulo for subcutaneous injection.

I know firsthand what it's like to have a rare disease.

VIVGAR, also known as efgartigimod alfa fcab, and VIVGARDA HYTRULO, also known as efgartigimod alfa and hyaluronidase-qVFC, are FDA-approved prescription medicines for adults with generalized myasthenia gravis, or gMG.

This includes adults with any gMG antibody subtype, including triple seronegative, anti-acetylcholine receptor, or AchR, antibody-positive, anti-low-density lipoprotein receptor-related protein 4, or LRP4, antibody positive, and anti-muscle specific tyrosine kinase, or MuSK, antibody-positive gMG.

Triple seronegative means a person does not show anti-AchR, anti-LRP4 or anti-MuSK antibodies when tested.

In this episode, you'll hear from a person living with anti-AchR antibody positive gMG about their experiences with either VIVGAR for intravenous or IV infusion or VIVGARDA HYTRULO for subcutaneous injection.

I know firsthand what it's like to have a rare disease.