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).

The 3 rheumatologists I have seen are useless for PN of any cause. They deal with inflammation of joints and tendons and management of medications for inflammation and immunosuppression.

If nerves are involved they will always refer to a neurologist or neurosurgeon.

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.

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.