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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Lymphadenopathy And Pain In Upper Abdomen?

My name is Dr. Berger Marius and I'm a specialist in ObGyn and specialist in anaesthiology and intensive care. The question is not from my specialty but more a demand for help for my cousin. He is a 48 y.o. healthy. He visited your country,Bangalore, one year ago during a mision of Israely gv. Since 6 mo. he is suffering of generalised lymphadenopathy and pain in the rt. uper abdominal quadrant. All the tests including pet scan,US, blood, serology were negative except the reactive lymph nods on byopsy. The pain in the UAQ is intermitent. No changes in the bowel movents, no loss of apetite or wheight. May be you can help us to think of a disease that you met in the population you are taking care. Thank you
Thu, 29 Jan 2015
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General Surgeon,  's  Response
Hi.
Thanks Dr Berger Marius. Read the history about your cousin.
The reactive hyperplasia of the lymph nodes on biopsy after visit to Bangalore, India is suggestive that this may be in fact be reactive hyperplasia.
Yes, in India we get this picture very commonly.
I would advise you to give him a course of antibiotic and oral steroids like Deflazcort in tapering off dosage for 3 weeks and see if this helps.
If the nodes and pain in the upper right abdominal quadrant still remains, you can go for another biopsy to rule out Tuberculosis.
Also subject the node for TB PCR. If positive give ATT for 6 months.

The pain in the right upper quadrant of abdomen can be due to lymph nodes or biliary problems.
You mat go for repeat scan after 3 weeks of treatment if there is no relief within 3 weeks of the treatment as mentioned above.
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What Causes Lymphadenopathy And Pain In Upper Abdomen?

Hi. Thanks Dr Berger Marius. Read the history about your cousin. The reactive hyperplasia of the lymph nodes on biopsy after visit to Bangalore, India is suggestive that this may be in fact be reactive hyperplasia. Yes, in India we get this picture very commonly. I would advise you to give him a course of antibiotic and oral steroids like Deflazcort in tapering off dosage for 3 weeks and see if this helps. If the nodes and pain in the upper right abdominal quadrant still remains, you can go for another biopsy to rule out Tuberculosis. Also subject the node for TB PCR. If positive give ATT for 6 months. The pain in the right upper quadrant of abdomen can be due to lymph nodes or biliary problems. You mat go for repeat scan after 3 weeks of treatment if there is no relief within 3 weeks of the treatment as mentioned above.