Rheumatoid arthritis in a child: causes, symptoms, diagnosis and treatment

Rheumatoid arthritis in a child is a very difficult and dangerous problem. This disease in modern pediatrics is relatively rare. Nevertheless, with information about its symptoms and the reasons it is necessary to familiarize each parent. The fact is that this disease can not be completely cured, but if timely time to begin therapy and preventive measures, the course of arthritis can be greatly facilitated and the probability of occurrence of dangerous complications can be reduced.

General information about the disease

Rheumatoid arthritis in a child, better known in medicine as juvenile rheumatoid arthritis (JRA), is a chronic disease of joints of autoimmune origin. For 100 thousand children there are approximately 16-19 patients with a similar diagnosis. According to statistics, girls suffer from ailment 2-3 times more often. In addition, the disease, as a rule, is diagnosed in children under the age of five.

The ailment is in fact very dangerous, as often the inflammatory process affects not only the joints (which in itself leads to degeneration of the articular structures), but also internal organs (eg, heart, eyes, etc.). The disease leads to a decrease in the quality of life of the child, and sometimes to a serious delay in physical development and disability.

Rheumatoid arthritis in children: causes

Unfortunately, the exact mechanism of the development of the disease is not yet clear. It is known that rheumatoid arthritis is an autoimmune disease. For some reason, the work of the immune system is seriously malfunctioning, as a result of which it begins to perceive articular structures as foreign bodies. Thus, antibodies are produced in the body, which first attack the cells of the synovial membrane of the joint, causing their inflammation and degeneration. As the disease develops, the immune system begins to damage other parts of the joint, and sometimes the tissues of the internal organs.

It is known that there is a genetic predisposition. There are other factors that can activate the development of this disease:

• A sharp change in the hormonal background (sometimes the disease is activated during puberty as a result of a jump in the level of hormones);
• Disturbances in metabolic processes;
• vaccination;
• Infection of the child's organism (it can be bacteria, viruses, mycoplasma, etc.);
• Severe overheating or hypothermia;
• Sharp climate change;
• Injury of the joint.

Rheumatoid arthritis in children: photos and symptoms of the joint form of the disease

Approximately 60-70% of patients suffer from this form of the disease. It begins, as a rule, with the defeat of one large joint (more often it is knee or ankle). After 1-3 weeks, another joint becomes inflamed. A characteristic feature is the symmetry of joint damage.

You can see that the child began to limp. There is a morning stiffness in the affected joints. You can also note swelling in the inflammatory process. Due to pain and limited movements, young children stop playing, move little - in a word, refuse physical activity, which is accompanied by discomfort. In the absence of treatment, this can lead to muscle atrophy.

As the disease develops, there is degeneration of the joint structures, which can lead to disability.

Articular-visceral form of the disease

The most severe is articular-visceral rheumatoid arthritis in children. Symptoms here, in addition to joint damage, include all the signs of intoxication, because the immune system damages the tissues of internal organs. As a rule, exacerbation begins with a sharp rise in temperature, chills, enlargement of the liver, spleen, lymph nodes. You can see swelling and redness in the area of the affected joints. The child suffers from severe pain.

The defeat of internal organs can lead to the development of amyloidosis, various diseases of the kidneys, heart, lungs, development of vasculitis, loss of vision, etc.

Generalized articular form of arthritis

Rheumatoid arthritis in a child can occur in other forms, for example:

• Oligosuscular chronic arthritis, which is accompanied by the defeat of 1-2 large joints (often knees) and a long, benign course of the disease;
• Polyarticular form of the disease, which is accompanied by the defeat of several large structures or a combination of small and large joints; The disease proceeds undulating.

Basic methods of modern diagnostics

Only a doctor knows how to correctly determine rheumatoid arthritis in children. Diagnosis is a long and complex process. Naturally, for the beginning a general examination is carried out, which allows to determine the presence of the inflammatory process in the joints. In the future, as a rule, laboratory tests are carried out. By the way, with juvenile arthritis, the rheumatoid factor in the blood is not detected at the initial stages of the disease in about 50% of cases.

Important for diagnosis are x-ray studies. Also, ultrasound of affected joints can be performed. More information about the state of the body can be obtained through computer tomography. If there is a suspicion of a visceral form of the disease, the doctor recommends electrocardiography, tests for bacteriological culture, and an examination with an ophthalmologist.

Basic principles of therapy in pediatric arthritis

Treatment of rheumatoid arthritis in children is a constant process, because, unfortunately, you can not completely get rid of the disease. Therapy in this case is aimed at inhibiting the inflammatory process, reducing the rate of degeneration of the joints, as well as maintaining their mobility.

In acute and subacute periods, as a rule, drug treatment is used, helping to eliminate inflammation. The periods of remission also include the holding of various recreational activities, including physiotherapy.

Medication Therapy

Naturally, for many parents, the question of how rheumatoid arthritis is treated is extremely important. Symptoms and treatment in children are closely related - the condition of the child depends on the list of medications used. All drugs can be divided into two groups:

• Drugs designed to eliminate the main symptoms during the period of exacerbation of the disease;
• Drugs that suppress the activity of the immune system (their patient takes throughout life, even during periods of remission).

As a rule, for the beginning children are prescribed non-steroidal anti-inflammatory drugs. The most effective of them include "Butadion", "Indomethacin", "Voltaren", "Ibuprofen". Naturally, the dosage and duration of the course of treatment are determined individually. By the way, these drugs act quickly, slow the development of the inflammatory process, relieve soreness and fever. In addition, they are not so toxic and have few side effects, which is very important for a child's body. For example, if rheumatoid arthritis is detected in a child (3 years) at the stage of exacerbation, then most likely the doctor will prescribe just such medications, and they are sold even in the form of suppositories, which is also convenient.

In more severe cases (for example, when generalized or visceral form), it is necessary to take corticosteroids, which cope with the inflammatory process much more effectively. As a rule, they are not prescribed for children under 5 years of age, but sometimes they make exceptions. Such drugs are used in the form of tablets and solutions, and sometimes are injected directly into the joint bag for maximum effect.

Alas, anti-inflammatory drugs can not slow the process of joint degeneration. Therefore, patients along with them are prescribed and so-called immunosuppressors - drugs that inhibit the activity of the immune system. The most effective include "Plakvenil", "Krizanol", "Sanokrezin", "Delagil." Such drugs should be taken by courses, but constantly, even during the period of remission, in order to prevent the onset of another exacerbation.

Depending on the condition of the child, the doctor can prescribe the use of cytotoxic agents (it is advisable for allergic-septic form of the disease), drugs that cause synovial coagulation (for example, "varicocid"), funds that provide a reduction in the level of rheumatoid factor ("Kuprenil").

Physiotherapy methods and their effectiveness

Treatment of juvenile rheumatoid arthritis in children at a later stage, in addition to traditional medication, may include physiotherapy. There are many methods that are used to achieve remission, but they are selected by the attending physician individually for each child.

Almost all children are advised from time to time to undergo therapeutic massage courses that help improve blood circulation, relieve muscle tension and strengthen them. Also, therapeutic gymnastics will help, which helps to keep joint mobility. Naturally, the pattern of exercises and exercises are selected individually, depending on the degree of development of the disease, the age and condition of the small patient.

There are many other methods. In particular, rheumatoid arthritis in a child is an indication for sanatorium treatment. Quite often effective are mud therapy, paraffin therapy, balneotherapy, etc. At later stages, treatment with currents is possible. With properly selected sets of physiotherapy methods and schemes for taking medications, you can achieve good results.

What are the predictions for a sick child?

What to expect if rheumatoid arthritis in a child is found? The forecast, unfortunately, is not very comforting. This disease is life-long and cure it completely, forever impossible. Exceptions include oligoarthritis, which is not accompanied by destruction of the joints. But the most severe is the visceral form of the disease, because the number of possible complications here is much higher.

What to do if a child has this disease? Timely and correctly conducted therapy allows to slow down the processes of destruction of joints and damage to other organs. There are cases when it was possible to achieve a long-term remission and significantly improve the quality of life of the child. On the other hand, with frequent relapses, a serious disruption of the basic functions of the joints is possible, which leads to disability.

Are there effective methods of prevention?

Rheumatoid arthritis in a child is chronic. And, unfortunately, there are no drugs or other methods of preventing the primary development of the disease in modern medicine. Nevertheless, if the child is at risk (for example, there is a genetic predisposition, allergic disease, chronic inflammation), then the so-called nonspecific prevention is possible, which includes the following conditions:

• Regular observation by a doctor. This may be a pediatrician or a rheumatologist who will constantly examine the child, follow the analyzes, etc. Because the disease is more or less associated with impaired immune system functioning, it is not superfluous to consult an immunologist.
• It is necessary to qualitatively treat chronic foci of infection, since such an inflammatory process can provoke the development of arthritis. Depending on the nature of the diseases, it is necessary to consult the ENT, dentist, nephrologist, cardiologist, etc.
• It is extremely important to exclude the contact of the child with infectious patients, because, again, the defeat of the organism by pathogenic microorganisms or viruses can give impetus to the development of arthritis.
• Also, doctors recommend to prevent excessive hypothermia and overheating of the body.

Observing these rules, you can reduce the likelihood of developing the disease or the occurrence of a relapse.