Great article MrsD - and very current. I do wonder though if the gender figures in some conditions (ie the predominance of women being affected) may reflect a cultural reluctance by men generally to seek medical help and therefore a recorded diagnosis.

I think its somewhat related to the soceity presentation of men. Appear as hypermasculine, superiority to feminism, and show no "Weakness" this is very prevalent in western society. An example would be a 6ft+ tall muscular male, blonde, blue eyes, with no defects or disease and very well off individual, thats how the world views males. And males in general dont like to go to the doctor,because of this. I see alot of males of this type at my school who are like this, always muscular or acting very masculine, into the whole "fitness,bodybuilder, or powerlifting" fad. It is good to keep a healthy body, but these are designed to be a way to show off thier psyche and masculinity. theres a video titled"mens standard of beauty around the world" on youtube. They describe how masculine, mostly white males are attractive. around the world.
I
skimmed the article, it is implying that some autoimmune diseases are more severe in one sex than the other, and vice versa. Also the ratio is not very clear cut, as they ONly refer to ADULT MALES in this article, so its not really accurate, because it does not include younger males, also the age of the females,pregnancies, also needs to be account. it is also not clear about the ratio, because there are so many autoimmune diseases out there, some like lupus,ms are known to be more predominant in females. This article only goes for highly industrialized countries, like the west, China and india is included. Furthermore, CHINA, india and USA have a much larger population, which includes immigration, so you would expect more autoimmunes to be happening than in the smaller european countries.
This is kind off topic from the OP, but he should only see a rhuemy if a autoimmune, or connective tissue disease is suspected.

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.

Seems like a visit to the rheumatologist should be part of the testing process for those of us idiopathic cases unless I am missing something.

Correct, Beatle.

Thanks En bloc. I am wondering if at 2.5 years post diagnosis, it would make sense to see one. I never have. I have mentioned it to my PCP but was told "they're just going to want to repeat a bunch of expensive tests to confirm what we already know, that you have peripheral neuropathy and it is incurable".

I've heard the "expensive" remark a few times and I do not understand it. So, because they are costly we should not do them? Why were they developed if they wrote going to be too expensive and therefore not utilized?

Anyway, should I consider seeing a rheumatologist?

They are notorious for repeating and running numerous labs/tests. But they will be looking at the autoimmune side of the problem (to determine if there is an autoimmune issue)...probably not what your neuro or PCP has explored.

I would still check one out, if I were you. If it's autoimmune based, then the signs would still be there 2.5 years later (not like AI disorders disappear).

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.

--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.

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.