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Forum Name: Neurology Topics

Question: Lupus or MS ? nobody seems to know


 ctcollins - Sun Dec 02, 2007 4:58 pm

Hello,
I am an 38 old male and for the past 18 months i have been out of work due to constant head aches and migraines,fatigue, dizzy,constant pain, ringing ears ( very loud ), sensative to sound causes myoclonic episodes, eye pain, blured and double vision, flashing lights and floaters. Lower legs, forearms, hands and face swell then go numb, all my fingertips are almost completely without sensation causing it hard to hold objects. I always wear sunglasses inside or out due to light makes my eyes and head hurt 4x worse, I also have a severe gait problem i drag both my feet and right foot is twitsted out to the right at about a 45 degree angle. I have to use a cain and still have problems with balance and falling, If i get in any moving object ( car, plane, train, etc. ) i get instant motion sickness and severe head and eye pain. I have myoclonic seizures and my right arm tremmors, i also have muscle pain and stiff muscles and joints and one day my right arm and shoulder locked into a certain position for about ten minutes and could not move it at all, same has happened to two of my fingers also. I have buring, itching extremely sensitive skin. I have had every test done at two different hospitols refered by my neurologist and have do definate answers to what is the cause, I've had 4 lumbar test that show my protein is at 114, 6 MRI's and the last one they thought i might of had a stroke, the MRI's on my spine show most of my dics to be degenerative and signs of mild to moderate spinal canal stenosis and mild to moderate bilateral neural foraminal stenosis, and i also came back possitive for autoimmune and ANA at 1:320 in nucleolar pattern, Creatinine 1.4 and high macrophage.I have had multiple eeg, emg, ct, blood, urine and all the eye test you could immagine but these are the only definate findings from all my test. If you have any thoughts i would be very happy to hear them.

Also, shoud i be concern that my protein level in my CSF has been around 115mg and my creatinine in my serum at 1.4 for over 18 months

Thank you for your time, CTCollins
 Dr. Chan Lowe - Wed Dec 05, 2007 10:02 pm

User avatar Hi Ctcollins,

This is a very difficult issue. Both MS and lupus can present insidiously and with non-specific symptoms. Your description does not make me think that it is Lupus. An ANA level of 1:320 is actually still within the range of what can appear in people without any disease. Commonly, with lupus the ANA titer will be in the thousands.

Unfortunately, this doesn't actually rule out lupus but I think it is probably less likely. MS certainly could cause all these symptoms but I would have expected that there would have been some changes on your brain/spine MRI consistent with this, especially if the MRI was done while you had symptoms.

Keep in mind, though, that both MS and systemic lupus erythematosus are clinical diagnoses and are not excluded by normal imaging/lab studies.

I wish I could be of more help but I can't come up with a great explanation for your symptoms. MS sounds the most likely. I can understand your frustration as cases like this are often just as frustrating to the doctor. Continued follow up is important.

If you have not seen a rheumatologist and a neurologist these would be good specialists to see.

Best wishes.
 FrancieK2100 - Thu Nov 05, 2009 5:58 pm

ANA Panel test - Is the anti-SS DNA of 212 indicate lupus as I have so many lupus symptoms? this is how the test results were sent to me. 212 is way over the 99. I'm confused by these test results. Thank you. fk
Component Your Value Standard Range
ANTI-SS DNA 212 0 - 99 U/ML
ANTI-DS DNA 0 0 - 40 IU/ML
ANTI-SM 63 0 - 89 U/ML
ANTI-RNP 34 0 - 83 U/ML
ANTI-SSA (RO) 32 0 - 91 U/ML
ANTI-SSB (LA) 44 0 - 73 U/ML
ANTI-HISTONE 111 0 - 96 U/ML
ANTI-SCL 70 8 0 - 32 U/ML
 ELEI - Sat Nov 07, 2009 11:20 pm

Have you had any test for Lyme disease? Do you recall any skin rash around the onset of your symptoms? Even if you don't and has tested negative for Lyme it doesn't mean you don't have it, because current lab tests lack sensitivity.

Lyme Disease can mimic both MS and Lupus, as well as other auto-immune diseases such as Arthritis, however treatment is antibiotic therapy. I would recommend that you see a lyme-literate physician and/or an Infectious Disease specialist and a Neurologist with knowledge in neuro-borreliosis. You can find information at IDSA website (Infectious Disease Society of America) and read the Lyme Disease Review Panel with the testimonies by Dr. Steven Phillips and Dr.Sam Donta.

Good luck!

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