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40 yr.old Male with muscle weakness/fatigue

My brother is a 40 yr. old Caucasian male with 5 wks of strange symptoms that no doctors have yet put together for a diagnosis. What could be a direction for us to take?
*healthy, very active until 5 weeks ago / Pittsburgh area plumber who does construction work
*non-drinker, non-smoker, slightly overweight
*extreme muscle weakness in both legs/ worsens upon activity-gets better with rest
*fatigue to the point of not being able to perform everyday activitites/worsening of symptoms
*general feeling of unwellness/poor appetite & nausea
*Emergency room twice for what was throught to be a heart atack-but all tests negative
*2 extensive CBloodCounts were neg., but one showed EBV antibodies (?)
*MRIs were neg./CT scan neg.
*Nerve studies were neg.
Could this be a virus?  First doctor prescribed corticosteroid dosepak; One doctor put him on 20mg. of Lexapro (?)
Any ideas?  Any good "House" type diagnostician in Pittsburgh area?
2 Responses
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351246 tn?1379682132
MEDICAL PROFESSIONAL
Hi
Thanks for writing to the forum!
Well chronic fatigue syndrome and fibromyalgia can be the possible diagnosis. Having said this I would still like to rule out other causes. Anemia, GERD, low blood sugar and an underactive thyroid all behave this way. These need to be ruled out first. Poor sleep patterns and sleep disorders are the other possibilities. Consult a sleep specialist too.
EBV antibodies do not herald the disease. It is positive in healthy individuals too. However one needs to link this with the symptoms. The type of antibody determines whether there is infection or not. “If you have positive VCA-IgM antibodies, then it is likely that you have a current, or had a very recent, EBV infection. If you also have symptoms associated with Mono, then it is most likely that you will be diagnosed with Mono, even if your Mono test was negative. If you also have positive VCA-IgG and EA-D IgG concentrations, then it is highly likely that you have, or recently had, an EBV infection.
If the VCA-IgM is negative but the others and an EBNA antibody are positive, then it is likely that you had a previous EBV infection. If you are asymptomatic and are negative for VCA-IgG, then you have not been previously exposed to EBV and are vulnerable to infection.” Refer: http://www.labtestsonline.org/understanding/analytes/ebv/test.html#what
Apart from this follow Corvin's advice too.
Hope this helps. I think you should discuss these possibilities with your doctor. It is difficult to comment beyond this without examining. A comprehensive investigation is required keeping all the points in mind. Please let me know if there is any thing else and do keep me posted. Take care!
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Avatar universal
Hi Nat5939,

The only thing I could add is to do a spinal tap and study the Cerebrospinal fluid (CSF). Also the MRI should have been of the head,and entire spine,and the CT should have been with contrast and involved the chest,abdomen,and pelvis. I don't know how much they scanned but if they missed any of these areas he should have more.

Did he notice any improvement with the steroids? Whether the cause was infectious or inflammatory he should have had temporary improvement while on the steroids.

I don't know any Gregory Houses' (good show ain't it) but finding a good Internist who has a broad knowledge of disease might be a good option.

Sorry I couldn't be more help,but I'll repost if I think of something else.
Helpful - 0
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