Sore throats swollen glands

During the early years of M.E, yes, but not anymore.

 

Sampling lymph nodes is a very unrewarding exercise. We did needle aspirations in the 1990s and learnt nothing much. They can diagnose cancer, that's about all. Biopsy removes the functioning node and is not justified unless you are looking for a clear diagnosis like lymphoma or TB. Cell populations vary enormously otherwise.

 

I was doing some searching on 'flu-like symptoms' as this is usually listed in 'other symptoms' for ME/CFS diagnosis.
However, it would appear that the individual symptoms and collectively 'flu-like symptoms' are also associated with anxiety and depression and even bi-polar disorder. There are many articles and papers on this.
But I was shocked to find so many. I haven't dug into it more to see when this association started as I suspected the whole mind-body thing ( There is this from 2009:
https://pubmed.ncbi.nlm.nih.gov/20035251/).

But the only symptom as part of the 'flu-like symptoms' that doesn't seem to get included as associated with a mental health disorder is 'sore throat' (I haven't really looked into swollen lymph-nodes).

(Some articles say that 'flu-like symptoms' are often referred to by the medical profession as 'general malaise').

 

Merged thread

Could someone please explain what is meant when it is said a sore throat is a symptom of cfs/me?

I have gotten to wonder if I have this or it's some other thing.

Nearing bedtime, my throat starts to get sore around my tonsils. Feels like the very early stages of a mild sore throat that you would get with a cold. But sometime in the night it vanishes. Returns most evenings so often Just don't think much of it anymore.

 

Ok, read those and a post made me now wonder something else. My sore throat doesn't seem to match what others are describing. But, now I am wondering.... I get swollen lymph nodes in my armpits. It's happened for long enough periods that I have been fully investigated and everything ruled out. No definitive explanation of what it is.

 

This happened to me a few weeks after I recovered from covid. Nothing was found and I never made the connection to long covid because I didn't know it was a thing in 2020.

 

Is there no good way to test with fine needle aspiration for what antigen made its way to the lymph node to initiate the swelling? Like with transcriptomics or proteomics to compare to before it was swollen maybe.

And isn't there a good chance there are new B cells and antibodies being produced if a lymph node is swollen? So would it make sense to see how the B cell/antibody repertoire changes in people whose lymph nodes swell after exertion?

I only know the basics. I learned that pathogens or self-antigens like cancer cells can initiate swelling, but maybe there are non-antigen triggers for swelling I have yet to learn about that don't lead to B cell proliferation?

 

We tried this sort of thing in the 1990s and it was clear that sampling problems made findings uninterpretable. That is not going to change with new omics techniques. It wasn't that you could not find things, just that because the tissue architecture is so variable and complicated you could never expect to get a representative answer.

 

Thanks. For the second part though, I was wondering about just testing antibodies in the blood after feeling/measuring a swollen lymph node. Is there expected to be a detectable increase in antibody a couple days after a lymph node swells that might give clues about the initiating antigen?

Edit: Remembering now that I think T cells could theoretically be activated and swell up a node without any activation of B cells. So it's possible no antibodies are produced.

 

I get sore lymph nodes in my throat and near the groin, very occasionally in the armpits. The body has lots! They feel tender to touch but don’t usually qualify as “swollen”.

 

Me too, in bad PEM. Seems to be the same as whatever's going on with the big swollen neck glands.

Sometimes I only have one sore underarm gland, sometimes it's both.

 

Mine are near my ovaries but I can tell it’s not them! Ovary pain is very specific lol.

 

You have to remember that an antibody repertoire is a bit like a jar full of lots of copies of 100 million keys each which will fit, more or less effectively, each of a million locks. You may know what about 500 of those locks are likely to be. How do you work out which lock stimulated what shift in the key population? It is only ever possible to interpret antibodies if you already know precisely what you are looking for and even then you may get a misleading answer. We are not expecting any obvious virus to be responsible. And as you say, it may just be the T cells reacting to the jar being shaken.

 

Me too, it's often one more than the other

 

I have a sore throat all the time that always worsens with PEM. My glands feel swollen a lot and also are worse with PEM.
I have asked two different GP’s on two different occasions to feel them and both times they said that they weren’t swollen, which just adds to their underlying disbelief of what I report about my illness. I don’t know if they are comparing the feeling to very swollen glands and if there is much nuance in what they can feel but I definitely know what I feel.

 

In the past I have had same issue when specific glands feel swollen to me and are tender or sore, but my GPs have said they don’t seem swollen. Perhaps unhelpfully I have not included swollen glands since when reporting symptoms to a doctor.

(However in general I only report symptoms that have changed or got significantly worse such that I feel the question ‘is this down to my ME/CFS or something new that may require treatment’ unambiguously needs answering. I suspect a full list of my symptoms would send any doctor running to a psychological referral. I don’t think I have given any doctor a complete overview since I stopped work in 2000, so some of my ‘newer’ symptoms have never been run past a doctor. For example I have never discussed my OI with a doctor.)

 

That makes sense about identifying the specific trigger being hard.

Though maybe just identifying if any specific antibody gene segments are consistently upregulated after vs. before a lymph node swells might be interesting. Like the VH3-30 research, but it seems to me like there's a possibility of a much stronger signal if only comparing people before and after a noticeable enlargement of a lymph node where those people are confident the swelling is tied to PEM. Maybe there won't be any new antibodies, but also maybe VH3-30 or something else sticks out like a sore thumb after PEM.

It'd be a chance to study only people with an objective symptom to keep it homogenous, and maybe also lead to an antibody biomarker of PEM.