ABSTRAK
Latar Belakang: Antibodi reseptor asetilkoline AntiAChR merupakan antibodi utama dalam patogenesis penyakit Miastenia Gravis MG . Pemeriksaan antibodi ini merupakan salah satu pemeriksaan penunjang penting dalam menegakkan diagnosa. Gambaran klinis MG dapat terbagi menjadi MG okular, MG generalisata dan MG bulbar dan masing-masing individu dapat memiliki derajat keparahan yang berbeda yang dapat dinilai dengan MG composite score. Penelitian ini bertujuan untuk mengetahui adanya hubungan kadar antiAChR dengan derajat keparahan penyakit MG berdasarkan MG composite score di RS Cipto Mangunkusumo.Metode Penelitian: Penelitian ini merupakan studi potong lintang cross-sectional deskriptif-analitik yang melibatkan pasien MG yang datang ke RS. Cipto Mangunkusumo pada bulan Januari 2017- November 2017. Kriteria inklusi subjek ialah pasien yang telah didiagnosa MG berusia 18-75 tahun. Pemeriksaan antibodi dengan metode ELISA Euroimun,German . Penilaian MG composite score dilakukan saat subjek bertemu peneliti bersamaan dengan pengambilan sampel darah. MG composite score bernilai 0-52, mencakup penilaian ptosis, diplopia, kemampuan menutup mata, fungsi mengunyah,fungsi menelan, suara sengau saat bicara, adanya sesak nafas, kemampuan fleksi leher, kemampuan abduksi bahu dan kemampuan fleksi panggul. Data dianalisis dengan SPSS 20.0.Hasil: Didapatkan subjek sebanyak 72 orang yang sesuai kriteria inklusi. Rerata usia subjek adalah 43 tahun SD 12,56 dengan jenis kelamin perempuan lebih banyak 2,5:1 . Gejala okular merupakan gejala terbanyak saat awitan 79,2 dan usia awitan 800 nmol/L . Tidak ada perbedaan bermakna seropositifitas antiAChR pada kelompok berdasarkan jenis kelamin, usia awitan, tipe MG, klasifikasi MGFa dan pemberian terapi imunosupresan. Tidak didapatkan hubungan bermakna antara kadar antiAChR dengan MG composite score p 0,727 , walaupun didapatkan median MG composite score pada seropositif antiAChR sedikit lebih tinggi dibanding seronegatif antiAChR.Kesimpulan: Kadar antiAChR tidak berhubungan dengan derajat keparahan penyakit MG.Kata kunci: Antibodi reseptor asetilkolin,dearajat keparahan MG,MG composite score.

---

ABSTRACT<>br>Background Acetylcholine reseptor antibody antiAChR is main antibody in pathogenesis of myasthenia gravis MG . Serum antiAChR testing is one of the important diagnostic test. MG clinical features can be devided into ocular MG, generalisata MG and bulbar MG and each individual can have different severity assesed with MG composite score. Aim of this study was to evaluate relationship between antiAChR with MG severity based on MG Composite score in Cipto Mangunkusumo Hospital.Materials and Method This was a descriptive analytic cross sectional study which were done to MG patients iwho attended to Cipto Mangunkusumo Hospital during January 2017 to November 2017. Inclusion criteria were 18 75 years old patients with diagnosed MG. The concentration of antiAChR was measured by ELISA method Euroimun,Germany . Assesment grading MG severity with MG composite score at the time subject met researcher and take a sampel serum for laboratory test. There are several assesment in MG composite score,including ptosis, diplopia, ability to close eyes, chewing, swallowing, slurring talk, breathing, ability to neck flexion, shoulder abduction and hip flexion and score ranging from 0 52. Data was analyzed using SPSS 20.0.Result There were 72 subjects MG met inclusion criteria. Mean age of the subjects was 43 years old SD 12.56 with proposion higher in women 2.5 1 . Ocular symptom is the most initial symptom and age of onset 50 years old early onset MG higher 77.8 than age ge 50 years old late onset MG . Generalisata MG common 80.6 than ocular and bulbar with median duration onset is 3 years. MG composite score mean 7 8 from maksimum score 52. 59.7 subject had seropositif antiAChR include three subjects had extreme titer 800nmol L . Additional analysis, there were no significant difference between seropositivity antiAChR with gender, age of onset, type of MG, MGFa classification and imunosupresan therapy. There were no association between antiAChR titers and MG Composite score p 0.727 , eventhough median MG composite score was higher in seropositif antiAChR than seronegative antiAChR. Conclusion Titer antiAChR did not correlation with MG severuty. Keywords Antibodi acetylcholine Reseptor, MG severity, MG composite score