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Suggest Treatment For Swollen Lymph Nodes On Neck Along With Fatigue
Question: I started this crazy road when I was 18. I got very sick swollen lymph nodes in my neck and very fatigued sleet slot and got sick a lot. Blood work would come back with Epstein Barr virus but no indication of mono. I had never had mono either. Over the next year I had many test even a false positive TB test lung X-rays fine. I then started with stabbing chest pain that would come in and get worse when I would breath. Did EKG found slight murmur and moved on. Finally after 2 years my doctor was planning a lymph node biopsy but the swelling went down. I was still very tired but I learned how to cope. Every 5 years from then on I would have the chest pain and just felt with it. I am now 39 and I started having the pains all the time I am also not able to fight the fatigue. I have constant back pain and I went to hospital and the did a lung X-ray and some blood work. My D dimmer was elevated and my Anion was low and they found damage in my left long and calcified lymph nodes in left and right and a nodeule on my spleen. They did a CT scan with XXXXXXX (bad reaction to dye) but they found some things there and referred me to a pulmonary specialist as soon as possible. I have in the past week started not to be able to drink alcohol at all without major stomach cramps within minutes of drinking just an aching abdominal pain. I have also noticed constant back pain and restless leg. I also have noticed the white of my eyes are turning yellowish and very bloodshot. From what I read this combination of symptoms even though very different relate I am wanting to seek your opinion.
Brief Answer:
Tissue biopsy alone gives definitive diagnosis
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Read and re-read carefully to understand the sequence of events and tried to correlate all.
My thoughts and opinions with explanation:
This is a 21 year old problem.
Started as enlarged lymph nodes in the neck, fatigued and sick. EBV positive in blood - but n FNAC or biopsy done.
False positive TB - might have been true TB as the findings are seen later as calcified lymph nodes (most suggestive of old healed TB).
Then stabbing chest pain, worsening with breath - mostly suggestive of pleurisy (can be due to TB as one of the reasons) or costochondritis and so on.
LN biopsy planned but unfortunately not done.
(Body takes care of all the infection and only when the resistance is low or when the body mechanism can not cope the signs and symptoms are exhibited.)
Chest pain every 5 years, learned to cope with.
Now you are 39 - pains, fatigue and constant back pain; X-ray, CT and other tests show damage to the lung and calcified lymph nodes hence referred to the Pulmonologist.
Alcohol causes severe abdominal cramps within minutes - suggestive of severe gastritis or intolerance.
Also have constant back pain and restless leg. White of the eye turning into yellow and is blood shot.
All these symptoms and their explanation still leads me to the cause as some granulomatous disease and need further investigations.
The biopsy of the diseased tissue is the only sure-shot way for a perfect diagnosis, rest of the investigations and clinical evaluation add to the clinical diagnosis and is driven by rule of high degree of suspicion.
I am hopeful that the Pulmonologist and/or any other specialist would definitely lead to a proper diagnosis by tissue biopsy.
I would advise in addition the following:
MRI of the spine at the painful area.
Blood tests for specific disorders like Quantiferon gold test for TB and the others that you should request for.
I hope this answer and explanation helps you for early diagnosis and treatment.
Tissue biopsy alone gives definitive diagnosis
Detailed Answer:
Hi.
Thanks for your query and an elucidate history.
Read and re-read carefully to understand the sequence of events and tried to correlate all.
My thoughts and opinions with explanation:
This is a 21 year old problem.
Started as enlarged lymph nodes in the neck, fatigued and sick. EBV positive in blood - but n FNAC or biopsy done.
False positive TB - might have been true TB as the findings are seen later as calcified lymph nodes (most suggestive of old healed TB).
Then stabbing chest pain, worsening with breath - mostly suggestive of pleurisy (can be due to TB as one of the reasons) or costochondritis and so on.
LN biopsy planned but unfortunately not done.
(Body takes care of all the infection and only when the resistance is low or when the body mechanism can not cope the signs and symptoms are exhibited.)
Chest pain every 5 years, learned to cope with.
Now you are 39 - pains, fatigue and constant back pain; X-ray, CT and other tests show damage to the lung and calcified lymph nodes hence referred to the Pulmonologist.
Alcohol causes severe abdominal cramps within minutes - suggestive of severe gastritis or intolerance.
Also have constant back pain and restless leg. White of the eye turning into yellow and is blood shot.
All these symptoms and their explanation still leads me to the cause as some granulomatous disease and need further investigations.
The biopsy of the diseased tissue is the only sure-shot way for a perfect diagnosis, rest of the investigations and clinical evaluation add to the clinical diagnosis and is driven by rule of high degree of suspicion.
I am hopeful that the Pulmonologist and/or any other specialist would definitely lead to a proper diagnosis by tissue biopsy.
I would advise in addition the following:
MRI of the spine at the painful area.
Blood tests for specific disorders like Quantiferon gold test for TB and the others that you should request for.
I hope this answer and explanation helps you for early diagnosis and treatment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
So with that type disease wouldnt i have been sick alot in my life and brinchitus and phneminia and other things? The Only health problem i have had since my symptoms cleared up at age 21 is an enlarged lymph node in the groin area that gets big then small then big again but never goes away the enlarged ines in my neck, i dint even get colds. The ONLY time i get sick is when i dont get 9 or more hours if sleep then my lymph nodes swell and i get a sore throat and fever. I have also been sweating so bad at night that i wake up dripping wet. I am a VERY healthy lady I work out but here lately going uo the stairs makes me lightheaded out of breath and my heart race and i dint understand why. All these years when ineiuld have thenchest pain i would gonto the ER do a chest xray and nothing. Even when I went 3 months ago all was clear all they saw was my heart irregularity. Could i have a chronic desese and have been totaly healthy all my life and no x ray show anything until this one when my D dimmer was elevated? I am just so confused because my weakness is effecting my work. Dizy light headed out if breath constant tight chest and back just all over pain. Sending a picture so you can see i am a healthy girl 5ft 4 132 lbs. and this picture also shows my eye color.
Brief Answer:
Biopsy is a must.
Detailed Answer:
Thanks for your feedback, additional information and the picture.
I think you should go for lymph node biopsies to get to the core of the disease.
Please consult a General Surgeon and insist on FNAC of all the nodes you have and the excision biopsy of the most suspicious lymph node.
R-rays do help as a screening tests and only CT scan show the better details, hence the normal looking X-ray is not the guarantee that everything is fine. This is the reason CT scan is more important and you have already got one done with the findings.
Can you please post the report of the CT scan of the chest?
Please feel free to discuss till you are satisfied.
Biopsy is a must.
Detailed Answer:
Thanks for your feedback, additional information and the picture.
I think you should go for lymph node biopsies to get to the core of the disease.
Please consult a General Surgeon and insist on FNAC of all the nodes you have and the excision biopsy of the most suspicious lymph node.
R-rays do help as a screening tests and only CT scan show the better details, hence the normal looking X-ray is not the guarantee that everything is fine. This is the reason CT scan is more important and you have already got one done with the findings.
Can you please post the report of the CT scan of the chest?
Please feel free to discuss till you are satisfied.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
This is the report the ER printed out and tod me i needed to show the lung specialist
Brief Answer:
Other reports please, if you can.
Detailed Answer:
Thanks for the reports.
The levels in some of the reports are on the borderline, even D dimer is just elevated hence not significant.
What about the CT scan of the lung report?
Other reports please, if you can.
Detailed Answer:
Thanks for the reports.
The levels in some of the reports are on the borderline, even D dimer is just elevated hence not significant.
What about the CT scan of the lung report?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
This is the only CT report i have right now
Brief Answer:
Granulomatous disease noted.
Detailed Answer:
Chronic lung condition - prior granulomatous disease is indicated in the CT scan reports.
Let us see what your Pulmonologist has to say.
Please give feedback .
Granulomatous disease noted.
Detailed Answer:
Chronic lung condition - prior granulomatous disease is indicated in the CT scan reports.
Let us see what your Pulmonologist has to say.
Please give feedback .
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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