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autoimmunity and PN

Posted: Sat May 14, 2011 5:06 pm
by christi
Scouring this site I found this on the general info page: "There are numerous possible causes for pudendal neuropathy. Some of the possible causes are an inflammatory or autoimmune illness,"

So my question is: Where can I find more information on the connection of autoimmunity and PN? I haven't heard anyone on the boards discussing this, but I assume that whoever wrote this must have had good reasons for including it as a possible cause.

My own research on medical websites shows that Irritable Bowel is associated with pelvic issues of various kinds.

Thanks in advance for any help!
--Christi

Re: autoimmunity and PN

Posted: Sat May 14, 2011 9:56 pm
by spikehades
hey, I know that in my early twenties I contracted espstein barr virus and had nerve pain and paraesthesias for months. It was initially diagnosed as fybromyalgia, but then i got better over a few months. the nerve pain was in my hands and feet, and I had problems sleeping thus one can conclude that it was systemic. Now my nerve problems are specifically loctated around the pathway of the pudendal nerve, with no other system wide pathology, therefore this time I feel it is a specific pathology.
I would say that unless you have systemic manifestations of pathology, then your nerve problems are not autoimmune.

Re: autoimmunity and PN

Posted: Sun May 15, 2011 2:51 am
by Violet M
christi wrote: Where can I find more information on the connection of autoimmunity and PN? I haven't heard anyone on the boards discussing this, but I assume that whoever wrote this must have had good reasons for including it as a possible cause.i
An autoimmune illness such as multiple sclerosis in which the myelin sheath is damaged or diabetes causing nerve damage could cause pudendal neuropathy. As far as finding scholarly articles on the subject that's tricky because most of us only have access to article abstracts rather than the full text of articles. But as Spikehead said, if it's due to an autoimmune disease you most likely will have other accompanying symptoms.

Here' are a couple of articles:

Neurophysiol Clin. 1997;27(1):51-8.
[Penile neuropathy: clinical and electrophysiologic study. Report of 186 cases].
[Article in French]
Amarenco G, Bosc S, Goldet R.
Source
Laboratoire d'urodynamique et de neurophysiologie, Centre hospitalier Robert Ballanger, Aulnay-sous-Bois, France.
Abstract
Penile neuropathy is a common disease due to lesion of the sensory branch of the pudendal nerve, ie, the dorsal nerve of the penis. Sexual disorders (deterioration of erection) and sensory signs (hypoesthesia or paresthesia of the penis) are noted in patients with penile neuropathy. Electrophysiological recordings help guide the diagnosis (reduction of the sensory velocity of the dorsal nerve of the penis). Many etiologies can be found (traumatic, toxic, compressive), but the most common lesion is neuropathy related to diabetes.

PMID: 9206758 [PubMed - indexed for MEDLIN

Int J Colorectal Dis. 1994 May;9(2):105-9.
Pudendal neuropathy in diabetic patients with faecal incontinence.
Pinna Pintor M, Zara GP, Falletto E, Monge L, Demattei M, Carta Q, Masenti E.
Source
University of Turin, Italy.
Abstract
To investigate the pathophysiology of faecal incontinence in diabetes mellitus, two groups of diabetic patients were studied: 14 subjects (7 females and 7 males, mean age 57 +/- 9 years) with faecal incontinence (Group A) and 15 subjects (6 females and 9 males, mean age 54.7 +/- 8 years) without faecal incontinence but affected by somatic peripheral neuropathy. A third group (C) of 10 healthy volunteers was used as controls. All subjects underwent electroneurographic evaluation of peripheral neuropathy, pudendal nerve terminal motor latency, anorectal manometry and rectal sensitivity tests. All the patients of group A had somatic peripheral neuropathy. Maximum squeeze pressure was lower in A compared to C (P < 0.025) and sustained for a shorter period in A compared with B (P < 0.0005) and C (P < 0.0005). All rectal sensitivity thresholds were higher in A compared with B and C. Pudendal Nerve Terminal Motor Latency was prolonged in 93% of patients studied in group A and in 73% of patients in group B (A vs B P < 0.005), with a significant difference in comparison with C: A vs C P < 0.0005, B vs C P < 0.005. Our findings suggest that somatic neuropathy plays an important role in faecal incontinence in diabetic patients, combined with sensation threshold impairment as a feature of an autonomic involvement.

PMID: 8064189 [PubMed - indexed for MEDLINE]

Re: autoimmunity and PN

Posted: Sun May 15, 2011 8:08 pm
by christi
Thanks, guys.
Actually, I'm very prone to a variety of mysterious autoimmune symptoms, different ones each couple of years. My blood work shows autoimmune problems that don't fit neatly into any particular diagnostic category.

So PNE could, theoretically, but an autoimmune situation... I'm just wondering if anyone else has a history of autoimmune issues?

Re: autoimmunity and PN

Posted: Sun May 15, 2011 10:23 pm
by TracyB7777
Sorry, no history here.

Re: autoimmunity and PN

Posted: Mon May 16, 2011 12:00 am
by Violet M
Christi, are your nerves affected anywhere else?

I have a history of autoimmune thyroid disease but if there's any connection to PNE it would have to be in some round about way. If your autoimmune disease caused an inflammatory state and you also had a musculoskeletal predisposition to PN I can see how there might be a connection.

Re: autoimmunity and PN

Posted: Mon May 16, 2011 2:31 am
by scaredgal
I have a history of non-specific auto immune arthritis. Started with arthritis in the thumb in 2002. Went away after 6 months, but during that time saw a very world renown rheumatologist who said I had inflammation in my sacroiliac joints. Fast forward to 2007, severe SI issues - no help with PT - DX with moderate sclerosis of SI joints - very uncommon at my age. Went back to same rheumatologist who said there had to be some arthritic inflammatory component to my issue - family history of ankylosing spondylotis, rheumatoid arthritis. PN start in July 2010 following over aggressive PT - who in the F knows.....

Re: autoimmunity and PN

Posted: Mon May 16, 2011 2:22 pm
by christi
If I knew that the PNE was an autoimmune syndrome (for me), I would relax, knowing that it was likely to go away by itself (as have my other autoimmune attacks). But there's no way of knowing...

Re: autoimmunity and PN

Posted: Tue May 17, 2011 2:44 am
by Faith
scaredgal wrote: PN start in July 2010 following over aggressive PT - who in the F knows.....
I didn't know your PN started from overly aggressive PT for SI issues. I'm pretty sure that's what caused my PN too or at least greatly worsened what was minor PN symptoms before during my pregnancy