Patient's Query
Hi doctor,
I am a 36-year-old male. For mild chest pain, I have had my chest x-ray PA view done as suggested by my rheumatologist. My doctor said that the X-ray report shows changes of chronic bronchitis in both lungs, more in the lower zones, and old fibrotic scarring is seen in the left apex. I am suffering from arthritis for which I am on medication. I have glaucoma.
My medication at present for arthritis is Cobix 200 twice daily, HCQS 200 once daily, Pan D before breakfast, Rosuvas once at night, Tryptomer 10 at night, Espidase DP, Folvite 5 mg, and Imutrex 15 mg once a week. Kindly suggest to me the medication according to the reports attached. Please do not suggest any other doctor or any hospital to me, as I want to get treated through your medication.
Thank you.
Hi,
Welcome to icliniq.com.
We are here to help you.
You are suffering from rheumatoid arthritis, and the findings of your chest x-ray (attachment removed to protect patient identity) can be due to the following reasons: Smoking, allergy, rheumatoid-related interstitial lung disease (ILD), and Methotrexate lung.
The treatment would be based on the symptoms that you might be experiencing. I would advise, in such a case, to first get an HRCT chest (high-resolution CT scan) along with sputum for AFB (acid-fast bacilli) done, which would rule out the evidence of tuberculosis. Rest for rheumatoid arthritis, your treatment is going in the right direction. Further treatment decisions would be based on a CT chest.
I hope that you get your answer.
Please let me know if you need any help.
Thank you.
The Probable causes
Investigations to be done
Preventive measures
Patient's Query
Hi doctor,
Thank you for your reply.
Thank you for your guidance. As suggested by you, we have performed a sputum for the AFB test. The result states that no acid-fast bacilli were seen. Please find the report attached for sputum. I have still not conducted the HRCT chest, as this scan is expensive for me. Request you to kindly suggest medication for the chronic bronchitis to be treated, for which I have attached a chest x-ray report rather than a CT. My weight is 141 pounds. What do you mean by Methotrexate lung?
Thank you.
Hi,
Welcome back to icliniq.com.
People suffering from rheumatoid arthritis can have associated interstitial lung disease. Even though one can develop Methotrexate lung following long-term use of the Methotrexate drug, as you have been taking it once weekly.
I would like to know the symptoms that you are feeling related to lung issues. So, treatment would be based on that. As far as the remaining treatment is concerned, you need to carry on the same. I would recommend that you see a senior physician in your area or a rheumatologist for the same.
I hope that you get your answer.
Please let me know if you need any help.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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