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What Causes Pain In Ribs After Having AKT4?
Question: Hi,
My sister is on AKT 4 medication for around 5 weeks now. She was suggested AKT 4 after she was having pain in the ribs. Subsequent xray, ct scan and mri were done which suggested lytic lesions due to infectious etiology. MRI images confirmed that there were no tumors. Consequent CRP and ESR tests confirmed infection as they were elevated than normal.
While on medication initially the pain became intense for the first 2 weeks. In the 3rd week the pain completely disappeared only to reappear again on the 4th week with lower intensity. Now in the fifth week she has become very weak and the pain also become intense at times. What should be done.
My sister is on AKT 4 medication for around 5 weeks now. She was suggested AKT 4 after she was having pain in the ribs. Subsequent xray, ct scan and mri were done which suggested lytic lesions due to infectious etiology. MRI images confirmed that there were no tumors. Consequent CRP and ESR tests confirmed infection as they were elevated than normal.
While on medication initially the pain became intense for the first 2 weeks. In the 3rd week the pain completely disappeared only to reappear again on the 4th week with lower intensity. Now in the fifth week she has become very weak and the pain also become intense at times. What should be done.
Brief Answer:
Second opinion essential. Please take her to a Chest Clinic
Detailed Answer:
Thanks for asking on HealthcareMagic.
AKT4 is a treatment for tuberculosis. It is not for just any infection that AKT4 can be given. For tuberculosis, it needs to be given for 6 months and then tested if tuberculosis is negative. It should not be given presumably. The basis of prescribing AKT4 needs to be justified first. Unless it is justified, it would not be rational to expect that the chest pain would go away.
You must visit a chest specialist, preferably in some RNTCP centre (Government tuberculosis treatment centre or chest centre) and get her reassessed.
Hope that helps.
Regards
Dr. Kunal Saha
Second opinion essential. Please take her to a Chest Clinic
Detailed Answer:
Thanks for asking on HealthcareMagic.
AKT4 is a treatment for tuberculosis. It is not for just any infection that AKT4 can be given. For tuberculosis, it needs to be given for 6 months and then tested if tuberculosis is negative. It should not be given presumably. The basis of prescribing AKT4 needs to be justified first. Unless it is justified, it would not be rational to expect that the chest pain would go away.
You must visit a chest specialist, preferably in some RNTCP centre (Government tuberculosis treatment centre or chest centre) and get her reassessed.
Hope that helps.
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
We did consult a Chest Specialist. After looking at the reports for xray, CT Scan, MRI he suggested that this should be handled by an Ortho Specialist. Our Ortho Specialist suggested AKT 4 medication.
The inflammation of the 2nd and 3rd ribs on the right have been there since last 10 years but the pain used to be very sporadic like once every month. We did consult doctors in the past and nobody could definitely give a solution.
However since last December 2014 the pain increased after which we visited a top hospital where she was suggested the tests above. After the results were out CRP and ESR test was suggested and it was found that the levels were above normal.
After having AKT4 medication for one whole month ESR and CRP test were done again and this time it was elevated than the initial tests. Our Ortho Specialist said that this is normal that initially the levels do spike up and then gradually decreases.
The issue that we are having now is sudden increase in pain in the bones. She also has to make movements very carefully to make sure there is no force on the ribs. What should be our next steps.
We did consult a Chest Specialist. After looking at the reports for xray, CT Scan, MRI he suggested that this should be handled by an Ortho Specialist. Our Ortho Specialist suggested AKT 4 medication.
The inflammation of the 2nd and 3rd ribs on the right have been there since last 10 years but the pain used to be very sporadic like once every month. We did consult doctors in the past and nobody could definitely give a solution.
However since last December 2014 the pain increased after which we visited a top hospital where she was suggested the tests above. After the results were out CRP and ESR test was suggested and it was found that the levels were above normal.
After having AKT4 medication for one whole month ESR and CRP test were done again and this time it was elevated than the initial tests. Our Ortho Specialist said that this is normal that initially the levels do spike up and then gradually decreases.
The issue that we are having now is sudden increase in pain in the bones. She also has to make movements very carefully to make sure there is no force on the ribs. What should be our next steps.
Brief Answer:
Could you please get a second opinion? Some tests are needed.
Detailed Answer:
Thanks for asking back.
I have gone through the details that you have provided. It seems that your orthopedician suspects bone TB. I suppose that he has justifications for the same and although the pain could increase, I still feel that some sort of confirmation is essential. Without it, it would not be possible to gauge the response to treatment. I feel that testing the blood for TB Quantiferon Gold Test or a TB-PCR test should be able to indicate if the diagnosis is correct. Please discuss about the same with your treating physician and if possible, get it done. Besides, if case of extra pulmonary tuberculosis, the regimen of AKT4 alone might not be enough. Considerations might also be made for the same.
Take care not to put pressure on the ribs.
Regards
Dr. Kunal Saha
Could you please get a second opinion? Some tests are needed.
Thanks for asking back.
I have gone through the details that you have provided. It seems that your orthopedician suspects bone TB. I suppose that he has justifications for the same and although the pain could increase, I still feel that some sort of confirmation is essential. Without it, it would not be possible to gauge the response to treatment. I feel that testing the blood for TB Quantiferon Gold Test or a TB-PCR test should be able to indicate if the diagnosis is correct. Please discuss about the same with your treating physician and if possible, get it done. Besides, if case of extra pulmonary tuberculosis, the regimen of AKT4 alone might not be enough. Considerations might also be made for the same.
Take care not to put pressure on the ribs.
Regards
Dr. Kunal Saha
Could you please get a second opinion? Some tests are needed.
Detailed Answer:
Thanks for asking back.
I have gone through the details that you have provided. It seems that your orthopedician suspects bone TB. I suppose that he has justifications for the same and although the pain could increase, I still feel that some sort of confirmation is essential. Without it, it would not be possible to gauge the response to treatment. I feel that testing the blood for TB Quantiferon Gold Test or a TB-PCR test should be able to indicate if the diagnosis is correct. Please discuss about the same with your treating physician and if possible, get it done. Besides, if case of extra pulmonary tuberculosis, the regimen of AKT4 alone might not be enough. Considerations might also be made for the same.
Take care not to put pressure on the ribs.
Regards
Dr. Kunal Saha
Could you please get a second opinion? Some tests are needed.
Thanks for asking back.
I have gone through the details that you have provided. It seems that your orthopedician suspects bone TB. I suppose that he has justifications for the same and although the pain could increase, I still feel that some sort of confirmation is essential. Without it, it would not be possible to gauge the response to treatment. I feel that testing the blood for TB Quantiferon Gold Test or a TB-PCR test should be able to indicate if the diagnosis is correct. Please discuss about the same with your treating physician and if possible, get it done. Besides, if case of extra pulmonary tuberculosis, the regimen of AKT4 alone might not be enough. Considerations might also be made for the same.
Take care not to put pressure on the ribs.
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Can you please elaborate, what do you mean by "Considerations might also be made for the same".
Can you please elaborate, what do you mean by "Considerations might also be made for the same".
Brief Answer:
Extra pulmonary tuberculosis has treatment regimens that are different
Detailed Answer:
Thanks again for writing back.
As I mentioned, treatment of extra pulmonary tuberculosis has treatment regimens that are different from the regular ones. Considerations are needed for the same. The following links should be helpful.
http://www.tbcindia.nic.in/pdfs/tuberculosis%20control%20in%20india11.pdf
http://bestpractice.bmj.com/best-practice/monograph/166/treatment/step-by-step.html
http://www.ncbi.nlm.nih.gov/books/NBK138753/
Regards
Dr. Kunal Saha
Extra pulmonary tuberculosis has treatment regimens that are different
Detailed Answer:
Thanks again for writing back.
As I mentioned, treatment of extra pulmonary tuberculosis has treatment regimens that are different from the regular ones. Considerations are needed for the same. The following links should be helpful.
http://www.tbcindia.nic.in/pdfs/tuberculosis%20control%20in%20india11.pdf
http://bestpractice.bmj.com/best-practice/monograph/166/treatment/step-by-step.html
http://www.ncbi.nlm.nih.gov/books/NBK138753/
Regards
Dr. Kunal Saha
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi,
Thanks a lot for the advice.
Thanks a lot for the advice.
Brief Answer:
Glad to be of service
Detailed Answer:
I am glad that it helped.
If you found my answer helpful, please close the thread with a positive review and a 5 star rating.
Regards
Dr. Kunal Saha
Glad to be of service
Detailed Answer:
I am glad that it helped.
If you found my answer helpful, please close the thread with a positive review and a 5 star rating.
Regards
Dr. Kunal Saha
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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