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-   -   Why does one see a rheumatologist? (https://www.neurotalk.org/peripheral-neuropathy/218504-rheumatologist.html)

Neuroproblem 04-09-2015 03:53 AM

Quote:

Originally Posted by mrsD (Post 1134447)
The basic premise of why women have more autoimmune issues is because of pregnancy.

Cells from the fetus do escape into the mother's body, and if she has the genetic propensity to react strongly to this, then she may develop an autoimmune disease.

The genetic markers have to be there however to trigger and fuel the autoimmune cascade.

Did you know that scientists have found cells from the fetus in mothers brains long after the pregnancy?

http://www.scientificamerican.com/ar...mothers-brain/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633676/

I think there is a very strong biological component to autoimmune disease in women. We are finding more and more surprises about this topic.

I brought this up because many doctors today, still do not think men get autoimmune disease, and may dismiss a male who is seeking testing and treatment.

So this posting today of mine is to forewarn the males here who might run into a biased physician.

Fetal cells actually protect the mother and offspring during and after pregnancy specifically the heart, it helps in repairing damaged heart(infarctions) in mice, maybe this is why women are less likely to have certain heart diseases than men. I think autoimmune in women maybe due to thier hormones, specifically.

On an episode of mystery diagnosis, a lady was had a rare autoimmune disease to her own progesterone, which is caused when she gets her period.
@beatle they want those expensive test repeated, because the doctors can make profit off of it, unless your with an HMO.

glenntaj 04-09-2015 06:03 AM

I have found--
 
--that most rheumatologists are familiar with the anti-nuclear antibody vasculitic/connective disorders, they are not often familiar with a lot of the other autoimmune possibilities, even things like Hashimoto's thyroiditis, and certainly not with a lot of the autoantibodies to components of central and peripheral nerve (many have not heard of Purkinje, GM1, GD1, anti-sulfatide class antibodies, for example). Then again, many neurologists haven't heard of these, either.

I personally find the whole field of autoimmunity fascinating, given that the leading assumption for the cause of my acute-onset body-wide small fiber neuropathy was/is autoimmune molecular mimicry (I've done a LOT of reading on the topic over the years; moreover, my wife works in development for the SLE [Lupus] Foundation, and I get to see a lot of the research papers coming out of there, as well as related ones).

One of the aspects of the gender differences in autoimmune condition occurrence I've become aware of, and that ties in with Mrs. D's hormonal/pregnancy musings, is that the gender imbalance in occurrence is much more pronounced during the childbearing years. For pediatric patients (though they more rarely show autoimmunity) and for the elderly, the gender imbalances are no where near as wide. For lupus, for example, there's about a 9:1 female/male ration before age 50, but after 50 the ratio reduces rapidly until above 65 it's more like 2:1. This pattern also seems to happen in MS (the usually given 3:1 female preponderance also drops with age) and with things like psoriasis and Hashimoto's. One wonders if post menopause the factors that predispose females to autoimmunity become muted and that results in the ratios becoming more even.

en bloc 04-09-2015 07:51 AM

Everyone has interesting points about this subject. There are rheumatologists that are well versed in immune mediated neuropathy and there are those that aren't.

I guess I have been spoiled, as my treating physician at Johns Hopkins is BOTH a rheumatologist and neurologist. He specializes in the neurologic manifestations of rheumatic and autoimmune disease...with special interest in neuropathy associated with Sjogren's. He is the ONLY doctor in the entire nation to be both specialties.

He certainly would be helpful for several members here with documented immune mediated neuropathy (he only sees patients already documented with the combination). His name is Dr. Julius Birnbaum (located at Johns Hopkins), and although a detailed and time consuming process to get in to see him, it's well worth the wait.

mrsD 04-09-2015 09:09 AM

Our own MG forum demonstrates these gender bias changes.

It used to be that males begin to develop myasthenia gravis at around age 50 or later. Now we are seeing young males showing up on that forum, some with severe MG.

I have been thinking that it is the enormous push for vaccines that are triggering those who have the genetic markers for possible autoimmune disease.

Like Sorgren's... MG has a negative antibody testing group with severe symptoms. That fits in with the theory that not all the antibodies that cause these and other syndromes have not been identified (found) yet. Glenn often mentions this aspect to the antibody testing explanations that he generously provides here on PN.

Neuroproblem 04-09-2015 04:18 PM

Quote:

Originally Posted by glenntaj (Post 1134600)
--that most rheumatologists are familiar with the anti-nuclear antibody vasculitic/connective disorders, they are not often familiar with a lot of the other autoimmune possibilities, even things like Hashimoto's thyroiditis, and certainly not with a lot of the autoantibodies to components of central and peripheral nerve (many have not heard of Purkinje, GM1, GD1, anti-sulfatide class antibodies, for example). Then again, many neurologists haven't heard of these, either.

I personally find the whole field of autoimmunity fascinating, given that the leading assumption for the cause of my acute-onset body-wide small fiber neuropathy was/is autoimmune molecular mimicry (I've done a LOT of reading on the topic over the years; moreover, my wife works in development for the SLE [Lupus] Foundation, and I get to see a lot of the research papers coming out of there, as well as related ones).

One of the aspects of the gender differences in autoimmune condition occurrence I've become aware of, and that ties in with Mrs. D's hormonal/pregnancy musings, is that the gender imbalance in occurrence is much more pronounced during the childbearing years. For pediatric patients (though they more rarely show autoimmunity) and for the elderly, the gender imbalances are no where near as wide. For lupus, for example, there's about a 9:1 female/male ration before age 50, but after 50 the ratio reduces rapidly until above 65 it's more like 2:1. This pattern also seems to happen in MS (the usually given 3:1 female preponderance also drops with age) and with things like psoriasis and Hashimoto's. One wonders if post menopause the factors that predispose females to autoimmunity become muted and that results in the ratios becoming more even.

dont forget that autoimmunity is also not gender related, its also environmental. I posted in another thread, where the lack of exposure to microbes in early childhood will contribute to the autoimmune factor, this is becoming an increasing part of research. The more cleaner we are the more likely we will suffer cancers and autoimmune. In industrialized, and lising countries, autoimmune, allergies, cancers, are the predominant diseases, including inflammatory. At a young age, our immune system needs to develop by being exposed to non-infectious and infectious microbe to properly develop.
Something like chickenpox,measles mumps are mild illnesses in children, while teens and adults who get these for the first time can be much more severe.

Tunaboy 04-16-2015 10:59 AM

Oh boy. It seems like Rheumatology is more geared towards joint/muscle issues. Why do I have a feeling once I see one, they will just refer me to a Neurologist?

How about a pathologist? immunologist? Just looking for someone who can do lots of lab testing for possible causes.

en bloc 04-16-2015 01:36 PM

What exactly are you looking for in "labs"? If you are looking for autoimmune conditions, then a rheumatologist IS the doctor you want.

Most immunologists focus more on allergies and immune deficiencies. There are some that work with autoimmune disease, but you need to search them out.

A rheumatologist will run a ton of labs...they are notorious for this and extended consults/exams as well. My last trip to the rheumatologist, he took 13 tubes of blood (and some were to run more then one test from same tube).

anon050715 04-16-2015 01:40 PM

Quote:

Originally Posted by en bloc (Post 1136016)
What exactly are you looking for in "labs"? If you are looking for autoimmune conditions, then a rheumatologist IS the doctor you want.



Most immunologists focus more on allergies and immune deficiencies. There are some that work with autoimmune disease, but you need to search them out.



A rheumatologist will run a ton of labs...they are notorious for this and extended consults/exams as well. My last trip to the rheumatologist, he took 13 tubes of blood (and some were to run more then one test from same tube).


Wow! 13 tubes...I've never had anywhere near that much blood taken from me lol


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