Juvenile arthritis - causes, symptoms and treatment of juvenile arthritis

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Juvenile arthritis - causes, symptoms and treatment of juvenile arthritis
Juvenile arthritis - causes, symptoms and treatment of juvenile arthritis
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What is juvenile arthritis?

Juvenile arthritis is a disease that develops in children under 16 years of age. With its development, patients experience 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 starts the process of self-destruction as it progresses.

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

Multiple 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;
  • girls are diagnosed with this disease 2 times more often than boys;
  • very often, patients treated for juvenile arthritis lose their ability to work at a young age;
  • Stage 1 olinoarthritis (a form of juvenile arthritis) affects 35-40% of patients;
  • Stage 2 olinoarthritis (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:

juvenile arthritis
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 affected. 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 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 older, 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: the joints of the lower and upper extremities, jaw, neck and neck.
  • Arthritis that develops after an injury. Some patients who are diagnosed with this form of arthritis have suffered from skin diseases for several years. Sometimes this arthritis affects the bones, tendons, spine, and joints. Most often, this disease is detected in boys under the age of 8, in whom men in the family suffer from spondylitis.

Juvenile arthritis is classified by clinical and anatomical ability:

  • 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, Stilla;
  • a form of arthritis with limited visceritis, in which vital organs (lungs, heart, etc.) are affected in patients.

Symptoms of juvenile arthritis

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

  • pain in the affected joints;
  • stiffness of movements (usually appears after waking up from sleep);
  • joint swelling;
  • limping;
  • changing gait;
  • increase in temperature;
  • weakness, lethargy;
  • rashes on the skin;
  • drastic weight loss;
  • growth slowdown;
  • febrile fever;
  • changing the length of the upper or lower limbs;
  • eye problems (pain, redness, inflammation, blurred vision);
  • irritability, frequent mood swings, etc.

Causes of juvenile arthritis

Causes of juvenile arthritis
Causes of juvenile arthritis

The causes that provoke the development of juvenile arthritis include the following factors:

  • viral and infectious diseases transferred by the patient that provoke an autoimmune reaction in the body;
  • hereditary predisposition to arthritis;
  • active functioning of the patient's immune system, against which the destruction of joint tissues occurs;
  • hypercooling of the body;
  • long exposure to the sun;
  • violation of the vaccination schedule;
  • joint injuries;
  • patient's genetic predisposition to arthritis, etc.

Complications

Many patients who have undergone comprehensive treatment for juvenile arthritis may develop various complications:

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

Diagnosis of juvenile arthritis

Diagnosis of juvenile arthritis
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 sent for additional diagnostics. To do this, he will have to undergo a laboratory and hardware examination:

  • Clinical and biochemical blood tests (the purpose of the study is to determine the indicators of red blood cells, platelets, white blood cells, etc.).
  • Complete urinalysis.
  • A blood test designed to detect bacteria whose presence may indicate an infection in the bloodstream.
  • A test performed by an orthopedic surgeon who takes samples of synovial tissue and fluid.
  • Bone marrow testing for leukemia.
  • X-ray, during which specialists detect fractures and other bone damage.
  • Computer or magnetic resonance imaging.
  • Scanning of bone and joint tissues, through which any changes in their structure can be detected.
  • Testing for: Lyme disease; various viral infections; to determine the erythrocyte sedimentation rate; to detect antibodies that provoke the development of arthritis, etc.

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

Modern medicine defines 4 degrees of this disease:

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

In the event that, when a patient is diagnosed with juvenile arthritis, pronounced symptoms and signs of this disease are not found, 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.

Treatment of juvenile arthritis

Treatment of juvenile arthritis
Treatment of juvenile arthritis

Juvenile arthritis can develop as follows:

  • slow;
  • moderate;
  • rapidly.

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 treatment for juvenile arthritis are prohibited from:

  • any physical activity (jumping, running, active games, physical activity);
  • stay in the open sun;
  • limited food intake: protein, s alt, fat, carbohydrates, sweets.

Traditional treatment includes the following medications:

  • painkillers (aspirin, indomethacin);
  • anti-inflammatory;
  • immunotherapy (intravenous immunoglobulin is administered to patients);
  • drugs of the steroid group (to reduce swelling of the joint and relieve pain);
  • when various infections are detected, patients are given appropriate antibiotic therapy;
  • with an exacerbation of the disease, NSAIDs (nimesulide, diclofenac, etc.), glucocorticosteroids (for example, prednisolone) are prescribed;
  • stem cell transplantation.

Commonly prescribed drugs for juvenile arthritis:

  • Non-steroid drugs (anti-inflammatory). In 25-35% of cases, this drug has a positive effect on the patient. The course of treatment averages 4-6 weeks. The group of nonsteroidal drugs includes: tolmetin, naproxen, meloxicam, ibuprofen. As a side effect, disorders of the functions of the organs 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. This drug is often injected with sedative drugs.
  • Methotrexate. The dosage of this drug during therapy can be gradually increased (up to a maximum of 15 mg / m2 per week). The effectiveness of methotrexate directly depends on the form of juvenile arthritis and the stage of its development. As side effects, one can note: 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 maintain a lasting effect of therapy for many years, even after discontinuation of drugs.
  • Cyclosporin A. Prescribed for patients with febrile conditions.
  • Inhibitors. This group of drugs includes very effective means of combating juvenile arthritis. They are able to increase bone density and slow down destructive changes in them.
  • Antagonists. Positive and consistent results have been observed in treating patients with high calcium antagonists.

Physiotherapy procedures are mandatory for this category of patients:

  • massage;
  • laser therapy;
  • physiotherapy exercises;
  • mud baths;
  • paraffin or ozocerite applications;
  • phonophoresis (when drugs are involved);
  • UFO, etc.

Patients with severe juvenile arthritis are often shown to have joint replacements. This is due to the fact that during the progression of this disease, they had a pronounced deformity of the joints, against which severe ankylosis developed.

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

The following foods should be in the patient's daily diet:

  • high in vegetable fats;
  • fermented milk products;
  • fruit;
  • vegetables.

Disease prognosis and prevention

Disease prognosis and prevention
Disease prognosis and prevention

The category of patients 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.

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

  • do not get cold;
  • minimize contact with patients with infectious diseases;
  • refuse preventive vaccinations;
  • do not take immune system stimulants;
  • lead a he althy lifestyle;
  • do not change climate zone;
  • do exercise therapy, etc.

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