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Neurology (Expert Forum)
Stiff Person or Endocrine problems
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Stiff Person or Endocrine problems
by sdegraff, May 26, 2005 12:00AM
In June 2004 my knees became painful when doing stairs or squatting. During physical therapy for my knees I began having mid-upper back pain. This back pain started in August 2004.
Some background: I am a 47 year old female - in June 2003 I had an adrenal gland removed due to Cushings. I am still on replacement hydrocortisone. In April 2004 I was diagnosed with hypothyroid and am on Levoxyl.
I have had extensive work ups including MRI’s, cat scans, bone scans for the back pain.
I had been shuffled from doctor to doctor for about 8 months; including internist, physiatrist, orthopedist, endocrinologist and neurologist.
In January 2005 a neurologist in Missouri suggested Stiff Person Syndrome because I tested positive for GAD65 antibody (low titer). I went to Mayo Clinic in Rochester for a second opinion. The neurologist there feels that the anti-GAD is of doubtful clinical relevance in my case.
The pain is in the thoracic area and I also have hypersensitivity of the skin on my back. I also experience hypersensitivity/burning of my skin in other areas of my body. The burning seems to come and go. Twice this hypersensitivity has occurred when my TSH was low so I have just recently decreased the levoxyl. While at Mayo they did sweat tests, autonomic tests and EMG’s, none which showed any significant abnormalities. I have also had blood glucose test for diabetes since the GAD could be indicative of that. I have also had workup for tumors.
Do you feel this positive anti-GAD could be related to my endocrine problems?
Some background: I am a 47 year old female - in June 2003 I had an adrenal gland removed due to Cushings. I am still on replacement hydrocortisone. In April 2004 I was diagnosed with hypothyroid and am on Levoxyl.
I have had extensive work ups including MRI’s, cat scans, bone scans for the back pain.
I had been shuffled from doctor to doctor for about 8 months; including internist, physiatrist, orthopedist, endocrinologist and neurologist.
In January 2005 a neurologist in Missouri suggested Stiff Person Syndrome because I tested positive for GAD65 antibody (low titer). I went to Mayo Clinic in Rochester for a second opinion. The neurologist there feels that the anti-GAD is of doubtful clinical relevance in my case.
The pain is in the thoracic area and I also have hypersensitivity of the skin on my back. I also experience hypersensitivity/burning of my skin in other areas of my body. The burning seems to come and go. Twice this hypersensitivity has occurred when my TSH was low so I have just recently decreased the levoxyl. While at Mayo they did sweat tests, autonomic tests and EMG’s, none which showed any significant abnormalities. I have also had blood glucose test for diabetes since the GAD could be indicative of that. I have also had workup for tumors.
Do you feel this positive anti-GAD could be related to my endocrine problems?
Doctor's Answer
by CCF-Neuro-M.D.-PW, May 31, 2005 12:00AM
Anti-GAD antibodies in HIGH titre are associated with stiff-person syndrome. Low titres are not and can be found in patients with endocrine problems such as diabetes mellitus.
Your symptoms are not suggestive of stiff person syndrome, so together with a low anti-GAD level, a diagnosis of stiff person syndrome is premature. The pain is more suggetive of a thoracic radiculopathy (pinched or inflamed nerve root in the back) which can occur from diabetes, Lyme disease, viral infections or a prolpased disc.
You should be check thoroughly for diabetes or glucose intolerance (pre-diabetes) with a formal glucose tolerance test if not done already
Good luck
Your symptoms are not suggestive of stiff person syndrome, so together with a low anti-GAD level, a diagnosis of stiff person syndrome is premature. The pain is more suggetive of a thoracic radiculopathy (pinched or inflamed nerve root in the back) which can occur from diabetes, Lyme disease, viral infections or a prolpased disc.
You should be check thoroughly for diabetes or glucose intolerance (pre-diabetes) with a formal glucose tolerance test if not done already
Good luck
Member Comments (2)
by sdegraff, May 26, 2005 12:00AM
Also, could the back pain be related to the endocrine problems?
by eyeman415, May 28, 2008 04:34PM
A related discussion, Anti-Gad positive and muscle stiffness during pregnancy was started.
