Sera from patients with myasthenia gravis (36 out of a total of 90) showed reactivity with epithelial cells in the thymus by means of the immunofluorescence technique. This antibody was cross reactive with skeletal muscle. All 9 sera of patients whose myasthenia was associated with a thymoma showed strong reactivity in serum dilutions of up to 1:60. Antigenic change in epithelial cells is postulated as a possible mechanism initiating an auto-immune response in the thymus.
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Geld et al. (1964) studied this question.