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How is RA and lymph nodal mass treated ?

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Practicing since : 2001
Answered : 11718 Questions
iam 25 years married women. i was diagnoised with RA recently and when doctor took all my joint xrays he told that i have a lymph nodal mass and he started giving me akta 4 tablet and Saaz ds for RA. after 3 months he changed AKTA 4 tablet to r-cinex 600 since 4 days iam using that tablet when i started using that iam feeeling like vomiting , drowziness,stomach problem. what are the symptoms of TB (as i dnt have fever ,cough,weight loss) will RA get reduced.
Posted Sun, 6 May 2012 in Bones, Muscles and Joints
Answered by Dr. Rakhi Tayal 1 hour later

Thanks for writing to us.

Getting a lymph nodal mass on joint x-rays is very uncommon as lymph nodes are not located near the large joints of our body.
Getting only lymph node swellings is not diagnostic of tuberculosis. However Joint TB or bone TB is usually diagnosed by X-ray only. Did the doctor say about Bone TB?
Did you have any other blood tests or tuberculin skin test for the diagnosis?
AKT-4 tablets and R-cinex both are meant for the treatment of tuberculosis only.
Saaz DS and celedol are the drugs that you are taking for RA. It helps in the disease modification and slows down the progress of disease. If there are no confirmatory tests, I think your doctor is doing trials on both Bone TB and Rheumatoid arthritis without proper confirmation. You should confirm with him about it.

The symptoms you are having now are the side effects of the anti TB drugs you are taking and are not uncommon. You can ask your treating physician to try using another brand of antiTB agents to reduce the side effects. Do not discontinue the treatment due to side effects as this may lead to drug resistance.

In Bone TB, Joint pain is more common. Ofcourse weight loss, generalized fatigue, low grade fever are uncommon. You can go for selective tests for antibody against TB by ELISA to confirm the diagnosis.

I hope this information has been both informative and helpful for you. If there are additional concerns, I am available for your followups.
Above answer was peer-reviewed by
Follow-up: How is RA and lymph nodal mass treated ? 3 hours later
Thank you for your reply. My doctor did not tell me that i have bone tb. my doctor has made me c.t scan of my chest and the report is like this
Multiple lobulated nonhomogeneously enhancing soft tissue density lessions along the right paratracheal,pretracheal,carnialand right hilar,largest measuring 3.7x2.3x3.8cm S/o conglomerate lymphnodal mass.
Discrete bilateral axillary nodes measuring 1.8x1.1cm

Antibody to Sm Antigen, serum by EIA     Positive (24.54)     
Positive: 20 and above
DNA (Double stranded) Antibody, serum     Negative     
Anti Nuclear Antibody-IFA     1:100 (positive)     
Sputum for AFB     Negative     
Typing of Anemia          
a)     PCV (%)     35.32     Male-(40-54), Female(36-47)
b) MCV(fl)     72.7     82-97
c) MCH(pg)     20.7     27-32
d) MCHC(%)     28.5     32-36
ESR(Wintrob)     23mm     
Liver Functional tests          
Total serum Bilirubin     0.9     
Direct (Conjugated Bilirubin)     0.3     
Unconjugated Bilirubin (Indirect)     0.6     
SGOT (AST)     38.4     
SGPT (ALT)     26.5     
Rhemothoid Factor (RF) IgG Antibody     292.8 U/mL
Rhemothoid Factor (RF) IgM Antibody     266.4 U/mL
Mountax test 25

and tablets iam using are
Tablet Name     How to use
Goodvit     Morning
Polybion 100mg     Morning
Repraz 20     Night
Admax 100mg     Morning
Saaz DS     Morning -Night
Celedol 100mg     Morning -Night
Akta 1 kit daily     Before breakfast
Benadione     ½ Night
wysolene     Morning 1-Night 1/2

please suggest me am i going in right medical treatment.please suggest me

Answered by Dr. Rakhi Tayal 14 minutes later

Thanks for writing back.

Having lymph nodal masses in the chest and axilla with positive mantoux test do point towards the TB but the diagnosis can be confirmed by ELISA test for Igm or IgG antibody against tubercular antigen.
The tests are positive for rheumatoid arthritis with anti- Sm ab positive and XXXXXXX positive.
I feel better now that you are getting the correct treatment. I would have put Repraz 20 in the morning empty stomach for a better effect. Ask this with your doctor.

Sincerely hope it will help.

Wishing you an early recovery.
Above answer was peer-reviewed by
Follow-up: How is RA and lymph nodal mass treated ? 1 hour later

Thank you giving reply very fast
can my arthrities get cured? is my Tb which i have is very dangerous? and which type of tb i have and is that contagious?can my tb cured completely? is there any relation for arthrities and tb? did arthrities came because of tb or vice versa?
Follow-up: How is RA and lymph nodal mass treated ? 5 minutes later
Is my Ra and tb both dangerous? will my Ra cured completely? is RA so dreadful disease? will i get pregnent because iam a newly married girl my husband side every one are about pregnancy and my joint pains. they are telling that its a very dreadfull diesease if u get ra u cant walk with out any support they are telling me like that true? please help me.
Answered by Dr. Rakhi Tayal 55 minutes later

RA is not a curable disease but definitely not debilitating as your family says or fears. You require early treatment and you will be fine. The symptoms can be relieved with medicines and further progress can be prevented upto some extent.

TB can be transmitted to other contacts of your family if they come in contact with your body secretions like saliva or blood. You will be fully cured of TB if you take the medicines properly and for full duration of treatment.

TB does lead to arthritis in normal cases. Your arthritis is an autoimmune disorder and not because of TB.

After you get fully cured of TB, you can very well get pregnant and produce babies. TB is a curable disease if the treatment is taken properly. There are no major disabilities like inability to walk, etc.

Be brave. You will be cured.

Wishing for your early recovery.

Above answer was peer-reviewed by
Follow-up: How is RA and lymph nodal mass treated ? 16 hours later
Thank you doctor for giving me rply. i want to ask u last question please answer to that as i told iam a newly married girl after marriage i came to know that i have RA and Tb where all my tests were done by my motherin law she took me to so many hospitals to show me i went to all the hospitals when the doctor told i have RA my husband side every one stopped talking to me. now iam in my parents house. recently i came to no through there relatives that they are planning for divorce by showing my medical records and they didnot give me my original medical record they kept with them. since 2 months even my husband is also not talking to me. can they give me divorce with my medical record? i want to live with him.please help me.
Answered by Dr. Rakhi Tayal 12 minutes later

I do sympathize with you. Your diseases are not so serious so as to be a cause of divorce as Tuberculosis has a permanent cure and RA can have symptom free life. So, please discuss about with your husband and in laws and educate them regarding this. To avoid such drastic decisions like divorce.

Hope I was in any help for you.

Above answer was peer-reviewed by
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