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In contrast, MuSK MG is due to autoantibody manufacturing by short-lived plasmablasts. MuSK MG autoantibodies are primarily associated with IgG4 subclass that could undergo Fab-arm change (FAE), an ongoing process unique for this subclass. In FAE IgG4, particles can dissociate into two halves and recombine along with other one half IgG4 particles leading to bispecific antibodies. Similarities between MuSK MG as well as other IgG4-mediated autoimmune conditions, including pemphig
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