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What Causes Swollen Lymph Nodes In Armpits, Collarbone And Neck Area?
Question: Hello! You will want to review my past medical problem over the past 5 months. I have been battling swollen lymph nodes under my arms and collarbone and neck area. The med center concluded there is no cancer in my body. The only diagnosis they gave after 2 months of testing was "reactive lymph nodes caused by non specific antigens. They referred me to a rhuematologist which I finally got in to see yesterday. Much to my disappointment, he had no answers and referred me back to a hematologist which I have already been to one. I am running daily fevers for going on 5 months now and they are getting worse. I also ache all over like I have the flu. I am fatigued beyond description. My general physician has given me brief rounds of dexamethasone for a week and prednisone for a couple weeks when I cant take it anymore. Tonite my fever wont go away. I am off all steroids until my hematologist visit on friday but dont know if I can last that long. I am taking aspirin, tylenol and ibuprofen rotating every 3 hours and that usually keeps fever down. It is not high 100.3, but high enough to make me miserable. Do you have any ideas what could be wrong ? Bear in mind the med center took 31 tubes of blood and ruled out just about everything. The rheumatalogist even mentioned stills disease, but that was not it. My skin around the swelled lymph nodes is red and hot. I have no joint pain. My question is if you have any ideas or should I just try to get into Mayo Clinic? I seem to have exhausted all other options. Pleae help. thanks.
I forgot to say that dexamethasone 4 mg which my doctor put me on for 7 days was the best 7 days in my life. No fever, no cough, no pain, no fatigue, lots of energy, but he didnt want me to be on it when I visit specialists so as to not mask my symptoms.
I forgot to say that dexamethasone 4 mg which my doctor put me on for 7 days was the best 7 days in my life. No fever, no cough, no pain, no fatigue, lots of energy, but he didnt want me to be on it when I visit specialists so as to not mask my symptoms.
Brief Answer:
Second opinion at Mayo / treatment as discussed.
Detailed Answer:
Hi Mr XXXXXXX once again.
I shall be happy to assist you again.
It was me who had suggested Deflazacort (Was not available on i pad of your Doctor) and you were given Dexamethasone. It is OK to hold Dexamethasone till you see a Hematologist.
It is bit saddening for me to know that the Rheumatologist was not of much help.
To recapitulate: daily fever for 5 months - cancers ruled out - ache all over like flu - fatigued - off steroids till visit with Hematologist on Friday - '' SKIN around the nodes is red and hot -
Your Query : any idea and whether to go to Mayo Clinic...
Yes, a second opinion of the Mayo Clinic Doctors may help to get a diagnosis.
May be a repeat FNAC / Biopsy / other tests help to clinch a diagnosis or at least they put you on a 'tapering dose of steroids or try other medicines.
I would suggest in such a patient the following on the basis of your history and our interaction till now:
-A course of Diethylcarbamazine for three weeks on 'empirical basis'; this is as per the history of red and hot skin around swollen lymph nodes.
This suggests me of some sort of ''lymphangitis'' problem related to the lymphatic system. Diethylcarbamazine course of 3 weeks may help.
-Doxycyclin once a day for 3 weeks or more. This an antibiotic. Can be taken for a long time.
-Steroids as before.
-Rest of the treatment as discussed in old threads (discussions) - avoiding the allergens which you might have noted to be increasing your problems.
Please discuss this with your Doctor and the Hematologist.
Empirical treatment means given on the clinical basis alone with a hope to get the results, tests may be negative.
Wishing all the best.
Regards
Dr T Chandrakant
Second opinion at Mayo / treatment as discussed.
Detailed Answer:
Hi Mr XXXXXXX once again.
I shall be happy to assist you again.
It was me who had suggested Deflazacort (Was not available on i pad of your Doctor) and you were given Dexamethasone. It is OK to hold Dexamethasone till you see a Hematologist.
It is bit saddening for me to know that the Rheumatologist was not of much help.
To recapitulate: daily fever for 5 months - cancers ruled out - ache all over like flu - fatigued - off steroids till visit with Hematologist on Friday - '' SKIN around the nodes is red and hot -
Your Query : any idea and whether to go to Mayo Clinic...
Yes, a second opinion of the Mayo Clinic Doctors may help to get a diagnosis.
May be a repeat FNAC / Biopsy / other tests help to clinch a diagnosis or at least they put you on a 'tapering dose of steroids or try other medicines.
I would suggest in such a patient the following on the basis of your history and our interaction till now:
-A course of Diethylcarbamazine for three weeks on 'empirical basis'; this is as per the history of red and hot skin around swollen lymph nodes.
This suggests me of some sort of ''lymphangitis'' problem related to the lymphatic system. Diethylcarbamazine course of 3 weeks may help.
-Doxycyclin once a day for 3 weeks or more. This an antibiotic. Can be taken for a long time.
-Steroids as before.
-Rest of the treatment as discussed in old threads (discussions) - avoiding the allergens which you might have noted to be increasing your problems.
Please discuss this with your Doctor and the Hematologist.
Empirical treatment means given on the clinical basis alone with a hope to get the results, tests may be negative.
Wishing all the best.
Regards
Dr T Chandrakant
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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