Since you have so many different systems affected, you need to rule out connective tissue disorders. Dystonia would not occur so late in age. Connective Tissue disorders are of two kinds, Heritable connective tissue disorders and Immune-related connective tissue disorders.
The main Heritable connective tissue disorders are: Marfan's syndrome, Ehlers-Danlos syndrome, Epidermolysis Bullosa and Osteogenesis Imperfecta.
The main Immune related Connective tissue disorders are : systemic lupus erythematosus, rheumatoid arthritis, scleroderma, polymyositis, and dermatomyositis. In addition to these, there is 'undifferentiated connective tissue disorder
' or ‘Mixed connective issue disorder
' which is used to classify those that do not fall into any category, plus combinations of any of these. You may be having a connective tissue disorder like Polymyositis.
Tests that are done are:
For all of the disorders: Raised antinuclear antibodies (ANAs) and antibodies to ribonucleoprotein (anti-RNP)
SLE: anti-DNA or anti-Sm (Smith) antibodies, falsely positive blood test for syphilis, anticardiolipin antibodies, lupus anticoagulant, or positive LE prep test.
RA: rheumatoid factor" can be found in 80% of patients. Citrulline antibody (also referred to as anti-citrulline antibody, anti-cyclic citrullinated peptide antibody, and anti-CCP).
Scleroderma: A particular antibody, the anticentromere antibody, is found almost exclusively in the limited, or CREST, form of scleroderma. Anti-Scl 70 antibody (antitopoisomerase I antibody)
Polymyositis; CPK or creatinine phosphokinase, aldolase, SGOT, SGPT, and LDH. EMG.
You must bear in mind that ultimately, a clinical diagnosis is the best diagnosis for connective tissue disorders.
You need to approach a Rheumatologist
for further investigations along this line. Rheumatologists are the specialists for connective tissue disorders.You can read up here:http://www.mayoclinic.com/health/lupus/DS00115http://www.merck.com/mmhe/sec05/ch068/ch068f.htmlhttp://www.medicinenet.com/mixed_connective_tissue_disease/article.htmhttp://www.mayoclinic.com/health/mixed-connective-tissue-disease/DS00675
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