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Questions for Dr. Kennedy
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Chest Inflammation
Posted by: jillandlily
Date: November 4, 2007 10:37 PM

I have had rheumatoid arthritis for 15 years. For the past few years (3 x times a year) I have had chest inflammation, which lasts about 6 weeks. Within the last few months I have developed sinus drainage that sits on the back of my throat and burns. I now have another episode of restricted breathing, burning throat, right rib cage pain and itching. I experience no shortness of breath during activity. This does not seem to respond to Celebrex, but Prednisone seems to help but not resolve the problem. I was a smoker, but never had a cough, shortness of breath during exercise or frequent episodes of bronchitis. I have had a lung scan, CT scan, numerous chest x-rays and a breathing test which are all normal. Liver tests are normal and I have had a abdominal ultra sound and HIDA scan (cholescintigraphy). I have four questions: 1. Is this early fibrosis, rheumatoid lung, or COPD, 2. what can I do to prevent further inflammation?, AND 3. why is nothing showing up on scans with all my episodes? and 4. Should I ask my rheumatologist to refer me to a pulmonary physician?

Edited 2 time(s). Last edit at November 5, 2007 12:29 AM by Dr. Kennedy.

Re: Chest Inflammation
Posted by: drron
Date: November 5, 2007 1:42 AM

Of course I can't diagnose you, but I can say that in similar cases a doctor would consider the possibility of rheumatoid pleurisy. That would explain your chest pain and restricted breathing and the fact that Prednisone helps but not cure and Celebrex has no effect. Your doctor may also want to consider the possibility of an infectious component in which case antibiotics would be in order as in any case of pleurisy. The sinus drainage in such a case could be related to dietary factors and possibly food intolerances. Common intolerances which cause excess mucus and sinus drainage are milk products and grains, particularly wheat.

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