Juvenile Arthritis - Causes, Symptoms And Treatment Of Juvenile Arthritis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Juvenile arthritis

Content:

• What is juvenile arthritis?
• Juvenile arthritis symptoms
• Juvenile arthritis causes
• Diagnosis of juvenile arthritis
• Juvenile arthritis treatment
• Disease prognosis and prevention

What is juvenile arthritis?

Juvenile arthritis is a condition that develops in children under the age of 16. With its development, patients have a characteristic swelling of the synovial membrane, which occurs due to the inflammatory process. Juvenile arthritis can be classified as an autoimmune disease in which the patient's immune system mistakenly begins to self-destruct as it progresses.

According to the available world statistics, juvenile arthritis is diagnosed when examining young patients in 0.6% of cases.

Numerous studies conducted by specialists from world-renowned medical institutions have shown the following:

• juvenile arthritis does not develop in children under 2 years of age;
• in girls, this disease is diagnosed 2 times more often than in boys;
• very often, patients undergoing treatment for juvenile arthritis become disabled at a young age;
• stage 1 olinoarthritis (a form of juvenile arthritis) affects 35-40% of patients;
• olinoarthritis stage 2 (a form of juvenile arthritis) affects 10-15% of male patients who have reached the age of 8.

Modern medicine defines the following types of juvenile arthritis:

• Systemic arthritis. This form of the disease is often referred to as Still's disease, with the progression of which the vital systems of the human body (heart, organs of the gastrointestinal tract, lymph nodes) are damaged. Patients have characteristic symptoms: rashes on the skin, an increase in temperature.
• Oligoarthritis. This form of the disease has another name - pauciarticular (juvenile) arthritis. During the first 6 months of the development of oligoarthritis in patients, 1-5 joints are affected. In most cases, various pathological processes develop in parallel. Most often, this form of the disease is diagnosed in young girls, and as they grow up, it can completely disappear.

• Polyarthritis. With the development of this form of the disease, more than 5 joints are affected in patients. Polyarticular arthritis is more commonly diagnosed in girls and can affect: joints of the lower and upper extremities, jaw, neck and back of the head.
• Arthritis that develops after trauma. Some of the patients diagnosed with this form of arthritis have suffered from skin diseases for several years. Sometimes, such arthritis affects the bones, tendons, spine and joints. Most often, this disease is detected in boys under the age of 8, in whom men have spondylitis in their family.

Juvenile arthritis is classified according to clinical and anatomical abilities:

• the articular form of arthritis, in which more than 5 joints are affected (if oligoarthritis develops, the patient is affected up to 4 joints);
• articular-visceral form, in which syndromes are detected: Wissler-Fanconi, Still;
• a form of arthritis with limited visceritis, in which the vital organs (lungs, heart, etc.) are affected in patients.

Juvenile arthritis symptoms

Juvenile arthritis is often asymptomatic, but in some cases it is accompanied by characteristic symptoms:

• pain in the area of the affected joints;
• stiffness of movements (usually appears after waking up from sleep);
• swelling of the joints;
• lameness;
• change in gait;
• increasing the temperature regime;
• weakness, lethargy;
• rashes on the skin;
• sudden weight loss;
• slowing growth;
• febrile fever;
• change in the length of the upper or lower limbs;
• eye problems (pain, redness, inflammation, blurred vision);
• irritability, frequent mood swings, etc.

Juvenile arthritis causes

The following factors can be ranked among the reasons provoking the development of juvenile arthritis:

• viral and infectious diseases suffered by the patient, which provoke an autoimmune reaction in the body;
• hereditary predisposition to arthritis;
• active functioning of the patient's immune system, against the background of which the destruction of the tissues of the joints occurs;
• hypothermia of the body;
• prolonged exposure to the sun;
• violation of the schedule of preventive vaccinations;
• joint injuries;
• the patient's genetic predisposition to arthritis, etc.

Complications

Many patients undergoing complex treatment of juvenile arthritis may develop various complications:

• secondary amyloidosis of the myocardium and organs of the gastrointestinal tract;
• macrophage activation syndrome (sometimes fatal);
• growth retardation;
• pulmonary and heart failure;
• loss of vision;
• deformation of the joints;
• loss of mobility (complete or partial);
• patient disability, etc.

Diagnosis of juvenile arthritis

Diagnosis of juvenile arthritis begins with a history of the disease. A narrow-profile specialist - a rheumatologist, conducts a personal examination of the patient, learns about his lifestyle, hereditary diseases, bad habits, etc. During the examination, the specialist palpates the areas of the affected joints. Without fail, the doctor must indicate in the patient's medical record all the symptoms of the disease and the patient's complaints.

After the initial examination, the patient is referred for additional diagnostics. To do this, he will have to undergo laboratory and hardware examination:

• Clinical and biochemical blood tests (the purpose of the study is to determine the parameters of erythrocytes, platelets, leukocytes, etc.).
• General urine analysis.
• A blood test, the purpose of which is to identify bacteria, the presence of which may indicate an infection of the bloodstream.
• Analysis performed by an orthopedic surgeon who collects samples of synovial tissue and fluid.
• Analysis of bone marrow samples to detect leukemia.
• X-rays, during which specialists look for fractures and other damage to the bone tissue.
• Computed tomography or magnetic resonance imaging.
• Scanning of bone and articular tissues, through which you can identify any changes in their structure.
• Testing for: Lyme disease; various viral infections; to determine the erythrocyte sedimentation rate; to identify antibodies that provoke the development of arthritis, etc.

During diagnostic measures, patients undergo special testing, the purpose of which is to detect antinuclear antibodies. This test shows the autoimmune reaction of the human body, in which self-destruction of the immune system occurs.

Modern medicine defines 4 degrees of this disease:

• high - 3;
• medium - 2;
• low - 1;
• stage of remission - 0.

In the event that, when juvenile arthritis is detected, the patient does not have pronounced symptoms and signs of this disease, the doctor will have to make a diagnosis based on the exclusion of other diseases:

• lupus;
• malignant neoplasms;
• bone fractures;
• infectious diseases;
• fibromyalgia;
• Lyme disease.

On the subject: Traditional methods of treating arthritis

Juvenile arthritis treatment

Juvenile arthritis can develop as follows:

• slow;
• moderate;
• swiftly.

The specialist prescribes the treatment of this disease only after a complex of studies, the purpose of which is to confirm the diagnosis. The method of therapy will directly depend on the type of juvenile arthritis and the stage of its development.

Patients undergoing therapy for juvenile arthritis are prohibited from:

• any physical activity (jumping, running, active games, physical activity);
• stay in the open sun;
• the use of food is limited: proteins, salt, fats, carbohydrates, sweets.

The traditional course of treatment includes the following medications:

• pain relievers (aspirin, indomethacin);
• anti-inflammatory;
• immunotherapy (patients are injected intravenously with immunoglobulin);
• steroid preparations (to reduce joint swelling and relieve pain);
• when various infections are detected, patients are given appropriate therapy with antibacterial medications;
• with an exacerbation of the disease, NSAIDs (nimesulide, diclofenac, etc.), glucocorticosteroids (for example, prednisolone) are prescribed;
• stem cell transplant.

Commonly prescribed medications for juvenile arthritis include:

• Non-steroidal drugs (anti-inflammatory). In 25-35% of cases, this drug has a positive effect on the patient. The course of treatment is on average 4-6 weeks. The group of non-steroidal drugs includes: tolmetin, naproxen, meloxicam, ibuprofen. As a side effect, disorders of the functions of the gastrointestinal tract, headaches and an increase in the activity of liver enzymes can be noted.
• Glucocorticoids. The drugs in this group have a number of side effects. Most often, there is a negative effect on the skeletal system. Sedatives are often prescribed when this drug is injected.
• Methotrexate. The dosage of this drug in the course of therapy can be gradually increased (up to a maximum of 15 mg / m2 kV. Per week). The effectiveness of methotrexate directly depends on the form of juvenile arthritis and the stage of its development. As side effects, it can be noted: the appearance of ulcers on the oral mucosa, nausea, disorders of the functions of the organs of the gastrointestinal tract, etc.
• Leflunomide and sulfasalazine. These medications are most effective in treating juvenile arthritis. Patients have a stable effect of therapy for many years, even after drug withdrawal.
• Cyclosporin A. It is prescribed for patients with febrile conditions.
• Inhibitors. This group of medicines includes very effective means of combating juvenile arthritis. They are able to increase the density of bone tissue and slow down destructive changes in them.
• Antagonists. Positive and lasting results have been seen in patients treated with antagonists containing large amounts of calcium.

Without fail, this category of patients shows physiotherapy procedures:

• massage;
• laser therapy;
• physiotherapy;
• mud baths;
• paraffin or ozokerite applications;
• phonophoresis (with the use of drugs);
• UFO, etc.

For patients with severe juvenile arthritis, prosthetics of damaged joints are often indicated. This is due to the fact that during the progression of this disease, they had a pronounced deformation of the joints, against the background of which severe ankylosis developed.

When undergoing a course of therapy, patients should adhere to proper nutrition. They must take vitamin and mineral complexes, which contain vitamins of group C, PP, B.

The patient's daily diet should include the following foods:

• high content of vegetable fats;
• dairy products;
• fruit;
• vegetables.

Disease prognosis and prevention

The category of patients who have been diagnosed with juvenile arthritis should understand that this disease will remind of itself throughout life. To prevent serious consequences, they must receive high-quality and adequate treatment, followed by rehabilitation.

Throughout the rest of their lives, patients should take preventive measures at regular intervals:

• do not overcool;
• minimize contact with patients with infectious diseases;
• refuse preventive vaccinations;
• do not take stimulants of the immune system;
• lead a healthy lifestyle;
• do not change the climatic zone;
• engage in physiotherapy exercises, etc.

Author of the article: Kaplan Alexander Sergeevich | Orthopedist

Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.