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painful lymph nodes and malaise for several months
May 5, 2002

Dr, For the past 6 months I have had a condition where my lymph nodes in my groin, arm pits and neck have been painful. The doctors I have seen are not at all impressed by the size of any of the nodes, but I feel them constantly all with varying degrees of pain that change constantly. I know the nodes are enlarged because I can no longer button the top button on my collar (very painful) and I cannot where my jeans anymore (painful in the groin). One node in my groin was biopsied 4 months ago and it was determined that I had "overactive nodes". In addition to the biopsy I had blood tests, cat scan and chest xrays all performed 6 months ago. Also I was seen by a an infectious disease doctor (she did not do any testing-just asked questions)My doctor is annoyed that I am asking for additional testing. What do you think I should do? Should I just go to another doctor? Any idea what my condition may be?

Response from Dr. Dezube

It sounds like you have many painful "reactive" nodes. That is what your biopsy showed. Are you HIV+? Your query does not indicate one way of another? "Reactive" nodes are nothing more than the body trying to fight off an infection. If you are HIV negative, then the nodes will calm down in time; If you are HIV positive, painful lymph nodes can persist. You've had CT scans, chest x-rays, blood work, and a biopsy-- that's a pretty good evaluation. It's important to keep an eye on the lymph nodes. If one grows out of proportion to the others, then a repeat biopsy may be necessary. Most likely a repeat biopsy will show the same. HOWEVER, if one or two lymph nodes is much different than the others, then that would be the lymph node which would pay to biopsy. On occasion, things do crop up over time. At this point, please get HIV tested, if you have not already done so. You ask, Does it pay to see another doctor? Perhaps, if it will be put your mind at rest. A second opinion never hurts. Time will tell what your condition is. Sometimes it takes time for diseases to declare themselves. Please realize that swollen lymph nodes are VERY common and do not necessarily signify a serious disease.


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