Comprehensive review on myasthenia gravis: patho-physiology, diagnosis, management strategies

Myasthenia gravis (MG) is a heterogeneous autoimmune neuromuscular disorder with distinct serological subtypes, including antibodies against acetylcholine receptors (AChRs), MuSK, and LRP4. Despite increasing recognition of these subtypes, clinical practice still lacks a standardized, subtype-specific approach to diagnosis, characterization, and management. Current treatment strategies are often applied uniformly, without fully accounting for differences in disease phenotype, prognosis, and therapeutic response among antibody-defined groups. This review provides a comprehensive overview of adult MG, focusing on the various autoantibody subtypes and their implications for pathogenesis, clinical features, diagnosis, and management. We highlight how combining serological findings with clinical subtyping can inform a more personalized approach to therapy and better align treatment decisions with disease biology. By emphasizing the clinical relevance of serological classification, this review aims to bridge the gap between immunopathological understanding and individualized patient care in MG.