Has anyone come across tubercular arthritis?

MsP

I have now been told that what was surgically removed from my lung is almost certain to have been TB. Its too late for pathology to test it and I can't now produce sputum so I am on TB treatment. I searched online and accidentally came across tubercular arthritis so I now wonder if my TB predated arthritis. I am waiting to discuss with my rheumatologist whether I should restart methotrexate. Despite my GP supporting this, I am very reluctant to do so, partly because I think I will need all my body's resources to cope with the TB antibiotics, also because I've been off it now for 5 weeks as I stopped because of surgery. I'm wondering, when I had fluid drained from my swollen knee if it should have been tested for TB. I never had the rheumatoid factor so was labelled with inflammatory arthritis.

Although it feels bizarre and very unexpected I am relieved to have a diagnosis and an excellent supportive team to monitor my treatment. As TB, unlike arthritis, can be cured, I count myself as extremely fortunate.

MsP

Hello I Have been taking methotrexate for inflammatory arthritis for about a year. Four weeks ago I had keyhole surgery for suspected cancer following a CT scan that showed a 10mm nodule and an ‘active’ lymph node in my right lung. It turned out not to be cancer (great) but TB which has been a massive shock. My GP wanted me to restart MTX but I’ve asked for a rheumatology opinion as I’ve been off it now for 6 weeks with no flare up so I’m wondering if what I had was tubercular arthritis. Evidently some health systems/ practitioners recommend TB screening for MTX and although I am recovering now from surgery I would have preferred not to have had the op and could have started TB treatment earlier.

YvonneH

Hi @MsP

I have put your last 2 comments together as they are related questions. I am glad you have now found out what the problem was with your lungs and that it is a treatable condition. Generally when we are on antibiotics we don't take methotrexate (MTX) however as it's a long process with Tuberculosis maybe you should take both. The only person who can help you here is your rheumatology team, has your GP referred you back to them yet? You can always phone them yourself and either chat to your rheumatology nurse or your consultant's secretary, I have found them to be very helpful, they can chat to the consultant and work out what you need and then they can feed back.

There are tests for TB, you can have latent TB (it is controlled by your own antibodies, you aren't infectious and don't feel ill) but I don't think it will be clear when you were infected. There are issues with some of the tests for TB.

However you are now on treatment, and it's going to get better, and with your rheumy team you can sort out your inflammatory arthritis and whether you are ready to go back on MTX.

Here is a link about the effects of RA on the lung, first posted by Kathleen T

https://www.nras.org.uk/the-effects-of-ra-on-the-lungs

Do let us know how you get on, as well as knowing how you are it will help lots of other patients if they find themselves in a similar situation

Take care

Yvonne x

debbielightbody

Hi,

I noticed you're post about having TB and wondered how you are getting along? I have RA and was on methotrexate and Humira. I was diagnosed in April 2020 with pulmonary TB and had to come off my RA drugs. Unfortunately it was multidrug resistant bovine TB, so only 2 of the 4 TB antibiotics work. 7 months on I still have a large mass in my lung which doesn't seem to have changed much.

I'm now wondering if it's more related to the RA.

@debbielightbody I've copied your post from the 'activity wall' of @MsP to their recent discussion so everyone can read and get help from your comment if they are in the same situation. YvonneH

Shell_H

Hi Debbielightbody, welcome to the online community!

Just to make you aware, you have posted directly onto another users "wall" - from your post I believe this was on purpose, but I just wanted to warn you that not many users make use of their wall, so you may do better doing a post on the main discussions instead.

I see you have Tuberculosis and Rheumatoid Arthritis, and the different requirements for drug use is being difficult! There is a definite correlation between TB and RA - but mostly because the immunosuppressant drugs used for RA can allow a latent TB to flourish (or at least that's what my reading seems to show - definitely listen to your health experts, they will know more!) I'd look into non-drug ways of managing your RA (do check our our information here: https://www.versusarthritis.org/about-arthritis/conditions/rheumatoid-arthritis/) and follow any advice your doctors give you. I know it's frustrating when it looks like nothing is happening, but they will be doing the very best for you.

Have a look around the rest of the community, and join in some of the discussions. The members are very friendly and welcoming, so please feel welcome.

Lovely to meet you,

Shell