Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Arthritis (Expert Forum)
Immune system and neurological problems
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
Immune system and neurological problems
by margy2, Mar 06, 2007 12:00AM
I am female, late 30s. Here is some history:
- three years ago dx with Trigeminal neuralgia and developed pins and needles left side. MRI showed large lesion in right lobe. Follow up confirmed 3 lesions in this area - told demyelination, and Probable MS, then told maybe not when EPs were clear
- Took Carbamazepine for pain then changed to Gabapentin 1 1/2 yrs ago
- 2 years ago had recurrent pneumonia and dx Bronchiectasis, also 4mm pulmonary nodule which has been stable for 2 years
- severe chest pain where pneumonia occurred and through lower breatbone when I get infections/fever, hence rheumatological work-up
- Bloodwork for rheumatology has all been clear including ANAs
- no joint pain, no depression/stress etc.
- I exercise regularly, eat well
- left side leg now is cramping, occasional coordination problem left hand, shocks down spine and through arms
- IGg consistently low, history since childhood of infection, IGg 1, 2, 3, 4 have been normal though so far in spite of low IGg. IGM and E and A were fine.
- recurring daily fever, and currently on antibiotic therapy to maintain functioning.
This is very confusing to me and doctors because it looks a little bit like various conditions but not completely like any of them - MS?, Lupus? Primary immune deficiency? I am fatigued and catch infections easily which start up neurological symptoms.
Question: Where do I go from here? I'm not sure what even has been ruled out/in or what needs still to be examined in order to stay well.
- three years ago dx with Trigeminal neuralgia and developed pins and needles left side. MRI showed large lesion in right lobe. Follow up confirmed 3 lesions in this area - told demyelination, and Probable MS, then told maybe not when EPs were clear
- Took Carbamazepine for pain then changed to Gabapentin 1 1/2 yrs ago
- 2 years ago had recurrent pneumonia and dx Bronchiectasis, also 4mm pulmonary nodule which has been stable for 2 years
- severe chest pain where pneumonia occurred and through lower breatbone when I get infections/fever, hence rheumatological work-up
- Bloodwork for rheumatology has all been clear including ANAs
- no joint pain, no depression/stress etc.
- I exercise regularly, eat well
- left side leg now is cramping, occasional coordination problem left hand, shocks down spine and through arms
- IGg consistently low, history since childhood of infection, IGg 1, 2, 3, 4 have been normal though so far in spite of low IGg. IGM and E and A were fine.
- recurring daily fever, and currently on antibiotic therapy to maintain functioning.
This is very confusing to me and doctors because it looks a little bit like various conditions but not completely like any of them - MS?, Lupus? Primary immune deficiency? I am fatigued and catch infections easily which start up neurological symptoms.
Question: Where do I go from here? I'm not sure what even has been ruled out/in or what needs still to be examined in order to stay well.
Doctor's Answer
by Kevin Pho, MD, Mar 07, 2007 12:00AM
, Mar 07, 2007 12:00AM
It is true that the symptoms and lab results are not specific to any one disease.
The diagnosis of MS can be further evaluated with a lumbar puncture and analysis of the CSF for oligoclonal bands.
Lupus can be evaluated with the ANA - if negative, it would be less likely that this disease is present.
As for immune disorders, common variable immunodeficiency can be considered - however appropriate testing with immunoglobulins has been done.
You can consider a neurology referral to further evaluate the pins and needles. Electrodiagnostic testing like an EMG can be considered. A second opinion with a neurologist can also be considered - preferably at a major academic medical center.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
The diagnosis of MS can be further evaluated with a lumbar puncture and analysis of the CSF for oligoclonal bands.
Lupus can be evaluated with the ANA - if negative, it would be less likely that this disease is present.
As for immune disorders, common variable immunodeficiency can be considered - however appropriate testing with immunoglobulins has been done.
You can consider a neurology referral to further evaluate the pins and needles. Electrodiagnostic testing like an EMG can be considered. A second opinion with a neurologist can also be considered - preferably at a major academic medical center.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
You may want to consider seeing a physician who is familiar with fibromyalgia and CFS. CFS affects your immune, nervous and endocrine system.