Crucially, we could not adequately account for critical variables such as MG autoantibody subtype (AChR, MuSK, LRP4), patient age, and specific immunosuppressive regimens-all of which are known to influence infection risks and therapeutic responses (Gilhus et al., 2018; Nelke et al., 2022). This evidence concerns the gene LRP4 and myasthenia gravis.