Q: My mother is 44 years old. She suddenly developed swelling in her ankles for the past 20 days, pain in the ankles, knees, lower back, etc. When the blood tests & X-rays were done an infection in the lower respiratory tract was found. Her haemoglobin is 12.3 gms% & the RBC count is 3.77 million/cmm. She is on antibiotics for the infection, along with iron & vitamin supplements. Is the swelling due to the infection or is it due to the anaemia?

A:Swollen ankles and painful joints are not caused by a respiratory infection unless the patient has developed a critical illness with heart or kidney failure. There is no obvious reason for mild anaemia to cause the symptoms unless there is an underlying problem such as a parasite in the bowel or muscles. This sounds like a collagen vascular disease, and a rheumatology specialist will need to evaluate the problems if they persist.