Alot of pain in the evening........
 

The last month., by 4 to 5pm all of my joints from toes up including my neck are stiff and painful. Is this from the MG?

Hello Whirlwind, :) You asked if MG is responsible for your joint pain. I wish we could answer your question. Finding a cause is often a process of elimination. So, for example, a visit to a Rheumatologist might shed some light on a cause. Myasthenics can be targets for other autoimmune/inflammatory disease.

There most certainly can be pain with myasthenia. Pain in the
shoulders and neck, which hold up the head, is one example, as well as
pain in the hips from perhaps, an unsteady gait.

Pain is in a sub-category. In other words, it's not a classic, or hallmark
symptom. Hallmark symptoms are a generalization, and so we have to try not to be angry at physicians who say there isn't pain with MG--they are, for the most part, talking about classic symptoms. However, they would be wise not to wave it off either.

Anything unusual to you, must be investigated.

I don't have a firm diagnosis, but do get IVIG for my mystery illness - i get wicked joint pains.. end of days usually worse.. my wrists are always extremely painful especially if i lean on my hands.. I feel 90 and am only 32! I do take plaquenil though which helps - my ANA is always quite elevated.. when I take motrin it's like a sweet relief of the aches!!

What did your doctor think of your elevated ANA? Most MGer have more than 1 autoimmune disease. It would not be surprising to have lupus too. I have autoimmune Hashimotos hypothyroidism and that causes joint and muscle pain. I would pursue the ANA. Did they tell you the pattern or the subtype of ANA? That might help to pin down a diagnosis.

Kahtie

Tests
 

The only tests I had were originally: Acetylcholine REC AB and ACHR Blocking ABS, Serum...What is a ANA, maybe I should have my Doctor order that test, what is it for?

Your neuro probably won't perform these test, because they are not his area of specialty. I would ask your GP for a referral to a rheumatologist. That is one of the problems in battling autoimmune diseases. There is not 1 doctor to handle autoimmune diseases, you have to find the right specialist that the autoimmune disease falls under.

I believe the statistic is 60% of people with MG have multiple (2 or more) autoimmune diseases. MG is most common found with RA, lupus, thyroid. All of these can cause joint pain too.

Your rheumatologist would probably want to do an ANA, RA, thyroid levels, c reactive protein and sed rate, CBC (pernicious anmeia is often found too) as well as Vit D and B12, folate levels. These vitamin defiencies are often found with MG or have symptoms that resemble MG or make it worse.

The good news is that some of the treatment will help the multiple autoimmune disease like immunosuppresants.

good luck,
kathie

Kathie - they all thought say whatever my issue is is autoimmune (i have very strong family history of autoimmune issues - celiac, lupus, brother with crohns). I have a rheumy - my lupus panel was negative - sjogrens borderline positive, . my ANA was speckled and hetero or homogenous (can't remember)! They talk about putting my on cellcept or immuran for all the issues, but immunosuppresants scare me, esp with young kids who are always bringing home something! I'll do it if need be though!

I do get a wicked livedo reticularis rash esp with heat, which is pretty impressive looking! (the rheumy pointed this out).

whirlwind- have they done heavy metal panels and all those others listed by kathie in the past? Were you seropositive for MG? I think i've had my thyroid checked 20 times in the past 2 years - as I scream hyperthyroidism (post partum).. but it's always normal, with the exception of a peroxidase test

I think if your peroxidase is positive, it is definitely autoimmune thyroiditis. Your thyroid level probably just have not changes enough yet. I would definitiely see an endocrinologist. Endocrinologist have recently narrowed their normal ranges of thyroid levels. I do not think most labs have done the same. I would suggest that you see an endocrinologist to evaluate those levels in light of your symptomology and other auto immune diseases. Endocrinilogist are more flexible now with treating based on symptomology and narrower level ranges.

I get the same rash in the sun, on my upper arms, shins and typical butterfly rash on face. GP thinks I may have Lupus too based on that 10 symptom criteria but my ANA is negative. Her suggestion was to schedule a rheumy appt and let myself get the rash and see what the rheumy says. Of course the weather would have to cooperate.

I am going to work on getting to Mayo to have all the autoimmune thoroughly accesses.

kathie