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Any suffered or suffering from a persistant cough since being diagnosed with RA?

I was diagnosed with RA in August this year and currently taking Hydroxycloroquine and Methotrexate (15mg). Haven't yet got up to the recommended dose of 20mg due to a cough and chest infection that started at the beginning of September. Was first prescribed 5 days of antibiotics and did improve a lot but still had a lingering cough. Then came back again, green phlegm in the mornings etc but GP said my chest was clear. Rheum. nurse sent off a sputum sample (uggh!) but I've never heard anything in the 2 weeks since. Again started to feel a bit better, not coughing so much for 3 or 4 days and now it's back again! Green stuff as before. Really fed up of it and don't know where to turn. I'm wondering if it's the Methotrexate but Rheum. consultant says not. She says it's becauses my immune system is still busy attacking my joints that it's not fighting the infection. I don't actually have any pain or swelling in my joints at the moment.

Anybody else suffered a similar situation? or can give any advice? I hope I've explained it well enough but I didn't want to go on and on about it. Thanks everyone.

5 Replies

Hi. I know that Methotrexate can cause a dry cough and some shortness of breath in some people-I was advised by my Rheum nurse to let her know if I had any problems. Did you have a chest x-ray prior to starting your Methx?-this can be a good baseline to compare any future chest problems against.Seeing that you've flagged it up and they don't feel it can be the meds it most likely is just the legacy of being a bit run down due to autumn bugs and starting treatment. Hope it sorts soon :)


If its green, then its usually infection, so surprised you haven't heard back from the doctor about the sputum test. Might be worth phoning and checking.

Its also possible to get lung side effects from DMARDS (pulmonary fibrosis) but you can also get the same thing as an autoimmune condition linked to other autoimmunes. I didn't think it usually involved green sputum though - more a dry cough and irritation. If it hasn't cleared in ages though, definitely ask your doctor about the possibility of having a chest xray. They can't always "hear" what is going on in your lungs.



It does sound very much like an ongoing infection I reckon. Because your immune system is being suppressed by the meds it can take longer for any infection to clear and it may well be that you need more/stronger antibiotics. Last time I was given antibiotics I was given stong ones and for 10 days, because the doctor recognised that I was immunosuppressed. Have the medics suggested stopping the mtx until the infection has cleared? Might be worth asking the question - some docs seem to say stop the mtx at the first sign of any infection, other say to carry on regardless. From my own experience the GPs are not always clued up on mtx so I wonder if it would be worth you calling the rheumatology dept for advice on this. It sounds as if chasing up the results of the sputum would be sensible too - because I guess that would tell them exactly what the infection was and which antibiotics might work the best for you.

Thinking of you and really hoping you can get this sorted soon.



After having a cough for six months and after X-rays I was given a high dose of steroids for seven days and alas it's gone that was last year having all your symtoms hope this helps you


Thanks everyone for taking the time to reply. As in previous weeks the dreaded cough has improved quite a bit the last 2 or 3 days. I take my second weekly dose of Methotrexate tonight (I take a split dose) and the last couple of weeks the cough has become worse on Friday evenings, 24 hours later. So I'm monitoring myself to see what happens this week! Hopefully all will be ok as I haven't been able to get the flu and pneumonia jabs because of it and need to get that done. Thanks again to you all. Wishing you all well. x


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