oligoclonal bands in CSF

[AshRN]

Hello I am a 25 year old female and four weeks ago I was diagnosed with optic neuritis, I was admitted to the hospital for 5 days of IV solumedrol therapy (1000 mg a day). After the treatment my vision mostly came back and the eye pain was completely gone. At the same time I also had a burning arm pain in my right arm with numbness and tingling into my fingers. During my hospital stay I had an MRI of my head, which was normal. I also had a spinal tap which showed 14 oligoclonal bands, my IGG synthesis was 6.1 and the IGG index is 1.6. I also had a envoked potential test that was abnormal. I was told that I may have MS, but that I shouldn't do anything else at this time. I should wait till the next flareup. Last night I got the lost the vision in my left eye again and the severe eye pain is back. I went to the doctor and have optic neuritis again. I had one of two treatment options IV solumedrol again or I could try oral prednisone, this is the option I choose for now, because I had many side effects from the solumedrol. I had to go on insulin, it made my gallbladder go bad and I had to have it removed, I also developed hospital acquired pneumonia from my immune system not working, and I also had lots of problems sleeping. Also this time I have heaviness in my legs with muscle twitching. I also have this problem that when I look down, I get a severe pain from my neck down my entire spine. Please give me any information about what to do next. Do you have to have a lesion on the brain to get a diagnosis of MS. All the research that I do says the sooner you start treatment the better off you will be. I am very concerned. I have 2 small children that I want to keep up with. Please post anything that might help

Thanks a bunch

[Garth L Nicolson, PhD]

I don't know if all of your problems are related, but in some patients essentially all of the multiple problems you listed were associated with chronic infections that invade many organs (vascular system, liver, thyroid, CNS, eyes, skin, etc.).  In complex cases like this where multiple diagnoses are present, we always suggest that chronic infections be considered.

[knightshotter]

I have been diagnosed with MS since 2004. I have positive spinal tap with elevated wbc, and IgG and interestingly NO oligiconal bands which are seen in 95% of MS population. , MRIs have shown multiple enhanced lesions each time I have a relapse. I failed solumedrol (steroid induced psychosis). I've been on copaxone every day since 2004. I continue to have severe progression of many symptoms esp respiratory weakness, facial weakness, leg weakness. I failed tysabri; allergic reaction. I did 2 doses of novantrone 3 months apart but they won't let me try again because wbc went down to below 1.1. I do not tolerate interferon like avonex or betaseron due to very high fevers. Most docs now refer to my MS as progressive relapsing.

Meanwhile I am separately diagnosed with behcets disease due to apthous ulcers-non herpetic on eyes, inside mouth and 1 episode on genitals. i am on colchichine and plaquenil.

More recently, saw a new rheumy due to many new symptoms. ANA was 1:80 borderline positive  nuceloated, and had antibodies + for scleroderma, have many areas of thickened skin on face, hands, also have severe episodes of reynaud's with changes in colors of fingers, white and blue, very sensitive to cold.; I have swelling of hands and feet, separately edema and now on lasix because got so bad. I have very dry eye and mouth; told sjogrens, had eye ducts cauterized..

Separatey I have vasculitis and hypercoagulation issues. i am on lovenox (not heparin) because still having heavy periods). I have very quick hypercoagulation problems and also factor 8 Leide n and factor V :leiden and anticardiolipin antibodies and antiphospholiopid syndrome. I am working with a MS neuro, a rheumy and a hepatologist/oncologist.  

Still not getting any answers. and keep waiting for next doc appts,.

Separately, liver doc was watching high liver enzymes so removed gallbladder 4 weeks ago. Have very high Alkaline phosphotaste over 300 and GGT over 480 (and have never drank alcohol in life), and liver enzymes were still in the 100s. liver biopsy just showed fatty liver. He has run tests first ASMA and AMA were positive , then ASMA was borderline, and thinks i have AIH but not sure...he wants the rheumy to monitor me on imuran. (i can't take prednisone due to psychotic behavior when on prednisone/solumedrol)...What will it take for rheumy to confirm definitely sclerodoma. I also have issues related to sclerodoma affecting mixed connective tissue, sjogrens, polymyositis, and chronic reflux, neuropathy (but also have MS); also have extensive esophageous inflammation. Seems like each specialist I see the ywant me to see someone else.

[Garth L Nicolson, PhD]

Although I can’t comment directly on your diagnosis, you should be aware that most MS patients, and this is especially true for atypical MS (not meeting all of the clinical criteria for MS), and patients who have MS-like signs and symptoms have chronic infections that can also cause many other symptoms unrelated to MS.  The most common infections found in MS patients include Chlamydia pneumoniae, Mycoplasma pneumoniae and other other species, Borrelia burgdorferi and other infections, including viral infections.

You might look into being tested for some of these infections, especially the ones mentioned above.