To the Editor: Drachman et al. (Sept. 23 issue)1 suggest that the functional activities of autoantibodies to acetylcholine receptors correlate well with the clinical severity of myasthenia gravis. This is an issue we have addressed for a number of years, reaching the opposite conclusion.2,3 It is well accepted that the clinical state does not correlate well with the antibody titer4,5 and that the degradation ratio correlates directly with the antibody titer.3,6 The logical deduction from these two premises is that the degradation ratio does not correlate with the clinical state. This difference in conclusion can be explained by an examination.
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