Does a tonsillectomy benefit people with inflammatory arthritis?
Q) I've recently been diagnosed with seronegative arthritis (presumed psoriatic arthritis at this stage). In addition to my rheumatologist I've been seeing a doctor specialising in nutritional medicine. She has suggested that removing my tonsils may benefit my arthritis. I did have a fair bit of tonsillitis as a child, and have some scarring on one tonsil, but have not had an episode since the age of about 12. I was wondering if you knew of any research where patients with inflammatory arthritis have benefited from tonsillectomy?
Angus Crawford, Bristol, Somerset (Summer 2006)
A) Tonsillectomy was a recommended treatment for rheumatoid arthritis many years ago, as was removal of bad teeth. This was done as it was believed that there was a link between throat (and tooth) infection and arthritis. Many people still believe there's a link, but not with the microbes which commonly cause tonsillitis. On the other hand, rheumatic fever, which we still see occasionally, occurs when the body ‘reacts’ to infection with certain microbes (streptococci) frequently found in tonsillitis. This association may have encouraged doctors to remove the tonsils in cases of rheumatoid arthritis. It's an interesting bit of historical medicine. The bad news is that tonsillectomy doesn’t prevent you from getting throat infections, which are most likely to be caused by viruses anyway. Nor does tonsillectomy stop you getting, and neither does it cure, arthritis.