PMR and swollen lymph nodes under arm pit, anyone?

Hi Kate

I do hope your symptoms have improved now that you have increased up to 12mg on the advice of your rheumy. However, that is a very fast drop you made from 20mg to 9mg following diagnosis in April and you may find it more successful to reduce a little more slowly next time around. I haven't personally experienced any arm pit swelling/tenderness such as you describe, and it may be best to check this out with your GP.

MrsO

Hi Kate.

I have had this problem for years, my very unhelpful doctor would offer to lance the boils I got under in my arm pits and in my groin, but never once did he offer me a reason why they occur or any medication.

I now have unsightly gatherings of skin where i have attempted to burst the boil with water as hot as I could bear, I cannot wear sleeveless tops they are so ugly.

I still occasionally get them in my groin but I have found the perfect solution, I use Elizabeth Arden eight hour cream and it bursts the boil, don't know what the magic ingredient is but just pleased it works.

Thanks to both of you for responding to my question. Regarding my prednisone decrease, I went from 20 to 15 to 12 then 9 was to be for one month and eventually go to 8mg

for a month. When I went from 15 to 12 I noticed a return of a few symptoms for just a day or two and then they were gone but at 9 mg. it's been two weeks with noticeable pain in my knees, ankles and thigh as well as the lymph node tenderness. It's only been 2 days since the increase so I hope I start feeling better. I was surprised to see how long many of the patients have been or will probably be on prednisone. I didn't think it would be so long!

I guess I'm worried that the swollen, tender lymph node could be something more serious, like lymphoma. I'm hoping it is just an additional symptom of the PMR and that others have had the same experience.

Kate

So it looks as though whereas 12mg was just containing the inflammation, the big reduction from 12 to 9 was just a step (or two!) too far.

The fleeting return of a few symptoms following your reduction from 15 to 12 were obviously withdrawal pains as luckily they resolved after only a couple of days, but it seems you may not have remained on 12 for long enough to really get complete control of the lurking inflammation - Prednisolone is not curing the disease but merely controlling the inflammation that causes the pain.

Unfortunately, there is no quick fix for PMR - it will go into remission when it wants to and that can take anything from 2 to 4/5 years.Some people have only managed to reduce successfully from 15mg by reducing 1mg at a time.

If you look at www.pmr-gca-northeast.org.uk you will find a wealth of information such as the British Society of Rheumatologists' Guidelines for the management of PMR. Also there is a very active forum where you will be able to exchange experiences with many PMR/GCA sufferers and read how they have managed to reduce successfully - pmrgca.forumup.co.uk.

Good luck with investigating those boils to put your mind at rest. I do remember many moons ago the rare hard lump in my arm pit and groin areas but have never experienced them since the menopauseand I remember putting them down to time of the month/hormones at the time!

MrsO

The swelling under my armpit isn't a boil but a tenderness when palpated. Nothing is visible and it's just enlarged from the other side. To be honest I was hoping others have experienced this symptom because my rheumatologist indicated on my first appointment that if his diagnosis of PMR didn't respond to the prednisone treatment in a few days we may be looking at a malignancy. Of course now my mind is rolling with thoughts of lymphoma. I responded very well to my original 20 mg. of prednisone and at my follow up appt. he felt assured it was PMR and began the program to reduce the prednisone. I will be seeing him next week at await his response. I'm also noticing more bruising that I understand can be a side affect of the prednisone?

hi first the lymph node its not a thing to dismiss so make sure everone has a good look at it ,malignancy tends to be fixed , because your adrenals are shut down by the steroids your immune system does not work well therefore it may well be a swollen lymph gland trying to fight an infection or you system is stressed because you are anxious . i am amazed how quickly you are reducing your steroids it has been proven that rapid reduction often leads to a quick return of pmr so be cautious and find the link suggested by the previous post . when you reduce if the symptoms come back quickly then improves this is withdrawels and you can expect to last at least a week if the symptoms come back more slowly but stay you have missed the optimum dose that is keeping the conditon under control therefore you need to go back to the dose holding it till the symptoms improve then reduce more slowly i reduce 1/2mg per month because when i went from 10 to 9 i had a terrible flare so nowi edge down slowly and i am back to 9 this time with no ill effects . i realise others go down more quickly but you have to learn to read your own body its not written in stone how to do this !!best of luck with it all come back to us with any ?? and make sure someone is keeping an eye on the node carolk

The recommended maximum reduction is 10% of the current dose. So at 12mg anything much over 1mg at a time is pushing it a bit. In the end, going slowly and steadily, 1mg at a time, will get you to the lowest dose for your disease at the moment just as quickly as rushing at the reductions, overdoing it and the symptoms returning meaning you have to go back to a higher dose and try to reduce again.

And this is what I meant by yo-yoing by the way - if you go too low and the symptoms return you will need a higher dose. Then you will try to reduce again - and some doctors never learn but try to get you to go in too big steps so that every time you have to go back higher as the symptoms return. When this happens the next reduction is often more difficult.

Your pred dose is only controlling the symptoms of an underlying disease process, almost certainly an autoimmune one. Nothing has been cured, just managed.

Eileen

Kate,

Its been awhile since you've updated, hopefully you have found that the lymph node was nothing serious such as a malignancy. I too experience swollen lymph nodes, both under my arms and in my neck...they become tender to the touch. It coincides usually with a slight feeling of flu like or general "yucky" feeling. I have read in some PMR medical documents where one of the symptoms can be running a mild or low grade fever and a general feeling of not being well (malaise). I know the PMR onset for me had something to do with my immune system, as it doesn't do its job but no exact reason can be found. I also noticed you mentioned your pain areas in your knees, ankles, and thighs...all areas among those that give me discomfort as well as the typical shoulders and hips. I have other areas as well, buttocks, forearms, and wrists, but you are one I've read who's challenges sound similar to mine.

I hope things are going better for you now.

Becky

I too, have PMR. Mine started exactly 1 year ago after having a bad case of strep throat . The bacteria went all over my body. I started out with 40mg of steroids and after decreasing slowly, I am down to 5mg. At this time, I haven't been able to go lower than 5, as my symptoms start flaring up. My heart goes out to all of you that have pain caused from this disease! The last 3 months I have started having some soreness under my left ear down my neck. I see my Dr. next month and will mention it, but after reading some post here I am thinking it is relater to PMR.

I have swelling on either side of my neck just above my collarbone.