In addition, although 5/65 patients did not reach the required increase of antibody titre to be classified as responders, all patients were considered protected against tetanus, according to WHO guidelines[37], and anti-AChR, MuSK or VGCC titres remained unchanged 4 weeks after vaccination; moreover, no myasthenic exacerbations were registered [36]. The gene discussed is MUSK; the disease is tetanus.