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What Do Elevated LFT Levels When Diagnosed With Bronchiectasis Indicate?

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Posted on Thu, 27 Aug 2015
Question: I have a 1.5 yr history of RA and a 15 yr history of Bronchiectasis (moderately severe). Initially I was prescribed Sulfasalazine for the RA, soon moved onto Methotrexate which seemed to work pretty well. 7 months ago I was taken off of Mtx. due to elevated LFTs. To be clear, I have had elevated LFTs (2x normal) off and on for several years, was throughly tested, scanned, and biopsied by a liver specialist who could never find a reason. I took Enbrel for 2 weeks and ended up with the flu. it took 5 weeks to recover. Then continued with the Enbrel for 2 weeks when I came down with pneumonia. That was 3 months ago - several rounds of antibiotics, 3 CT scans, and a bronchoscopy to find out it is a fungal pneumonia that I am now being treated for. Back to the RA. I am on nothing but meloxicam daily for the RA, it is rapidly progressing ( I need a joint replacement in my R hand) and I am on no DMARDs. My Rheumatologist (whom I haven't seen in a few months) is moving and I will follow up with one of his partners, whom I cannot get into see for another 2 months. I am self medicating with Toradol (left over from something else) with little effect. ADLs are becoming very difficult. I used to be an active person, not so much now, although I try. I am 58 yo. I guess my question is what can be done about treating the underlying disease and not just covering up the pain process? Is it unreasonable to try Mtx. again? What can I say to get in to see a new doctor earlier? I feel like the disease is causing irreversible damage not to mention the cardiovascular etc. effects it may be having. Thank you for your consideration.
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Answered by Dr. Dr. Praveen Tayal (19 minutes later)
Brief Answer:
DMARDs are needed.

Detailed Answer:
Hello,
Thanks for posting your query.
With a gradually progressing RA, DMARD is necessary to retard the progression of the problem. Taking only anti inflammatory pain killers is not sufficient.
Regarding DMARDs, right now methotrexate seems to be the most suitable option for you. Since all the liver pathologies have been ruled out, you can restart with methotrexate with regular LFT monitoring. But since it needs a close dosage regulation you will have to consult a rheumatologist for this.
You can request for an earlier appointment by describing the severity of your illness.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12307 Questions

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What Do Elevated LFT Levels When Diagnosed With Bronchiectasis Indicate?

Brief Answer: DMARDs are needed. Detailed Answer: Hello, Thanks for posting your query. With a gradually progressing RA, DMARD is necessary to retard the progression of the problem. Taking only anti inflammatory pain killers is not sufficient. Regarding DMARDs, right now methotrexate seems to be the most suitable option for you. Since all the liver pathologies have been ruled out, you can restart with methotrexate with regular LFT monitoring. But since it needs a close dosage regulation you will have to consult a rheumatologist for this. You can request for an earlier appointment by describing the severity of your illness. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal