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Elevated ANA with MG or MS?
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Elevated ANA with MG or MS?

Hi Doctors,

I am a 26 y/o M in good health.  I have been diagnosed with occular MG.  This Dx was made based on two + AcH-receptor binding(.3 and .4 with normal cutoff at >.1) and a slightly "intermediate" anti-skeletel (1:40, normal cutoff is 0-1:39).  No thyoma. I have SFEMG scheduled. I do not take any meds because the occular symptoms are very mild and not too bothersome.  However, my doc let me trial 60mg Mestinon several times a day to see if occular Sx got better but nothing happened to ptosis or M-diplopia (I am SURE it is monocular).  Doc also tested me for a bunch of other stuff, including ANA screen.  The ANA screen came back + (no titer reported).  On a side note, a few years back I posted and was fully tested (MRI, Evoked) for MS (twice) -- mostly for transient light parastesias in the back and neck.  These parasthesias, which were gone for at least a year, have returned.  
I am fully functioning, no symptoms of any disease except for parastesias, ptosis and m-diplopia.  CI am healthy and active and very anxious about this blood test.  No one in my fam has lupus or other aa disease.  I occasionaly have dyspnea that could last for days, docs attribute it to anxiety.  Pulm. Fx test ok.

1.  What is the significance of + ANA with MG?  Is it related or could I also have Lupus?
2.  Is it indicitive of MS?
3.  Should the Mestinon at 60mg. give relief of my eye Sx.
4.  Is Mestinon good at Tx dyspnea if it is caused by MG?
5.  What further testing should I get, and could you please tell me what to look for in results to help clarify the picture?

Thank
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The elevated ANA can be seen in other auto-immune disorders such as MG. The positive ANA is not indicative of MS. I am not sure what you mean by monocular diplopia. If you cover one of your eyes, and the double vision remains, this is monocular diplopia. However, monocular diplopia is not a part of MG, and usually indicates a problem within the eye. The Mestinon should help with binocular double vision and ptosis, but these also can be resistant to therapy with Mestinon. Also if the dyspnea was secondary to MG, it may respond to Mestinon.

With positive anti-bodies and a single fiber EMG, the diagnosis can be confirmed. There are no further tests I would recommend. Good luck.
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