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Suffering from granulomatous inflammation with tuberculous inflammation at cervical region. Reason for joint pain?

Hello doctor My Sister is 28 years old. She has been suffering from granulomatous inflammation consistent with tuberculous inflammation at right sided cervical region (detected by FNAC ).She has benn taking AKT-4 for last 3 months. Her recent blood test shows following results- 1.ANA- HEp-2010 Positive(++) Showing diffuse pattern, Primate Liver Positive(++) 2. Serum Uric Acid- 8.70 mg/dL Serum CRP(High Sensative)-1.56 mg/dL 3. Rheumatoid Factor-17.10 IU/dL 4.Haemoglobin-11.20 gm/dL 5. Total Leucocyte count-5900 / 6. Differential Leucocyte count N-65, L-32, M-2, E-1, B-0 7.ESR-Western Method- 90.00mm/hr Erythrocytes are predominantly normochromic and normocytic 8. Plasma Glucose Fasting- 88.00 mg/dL Recent nake USG result shows right sided cervical lymphadenopathy . She has also suffering from joint pain and joint swelling involving knee joint. I like to request you to tell me the reason of her joint pain? and if there is any further test is required. I also very afraid of her blood result regarding ANA ++, High range of Uric acid and CRP and High ESR. Please suggest me what to do. Best regards, Sourav D
Wed, 16 Apr 2014
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Orthopaedic Surgeon 's  Response
FNAC reports tuberculosis okay but auto-immune phenomena is also active in your sisters case. She must get in touch with a rheumatologist immediately to monitor and manage both the disease and joint pains. This has to be on periodical basis and some regular tests shall be needed.In auto immune discrepancy tuberculosis and some systemic diseases are to be carefully and intensively treated
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