Juvenile idiopathic arthritis in children: treatment

Juvenile idiopathic arthritis in children: what is it

Causes and risk factors

The word "idiopathic" in the name of the disease means that for today scientists do not know the exact reasons for its appearance.

It is precisely known that the disease has a hereditary connection and can be transmitted from generation to generation.

Also in academia there is a theory that arthritis is closely related to the state of the environment and they are more often sick with children from large industrial cities with poor ecology.

In addition, attention should be paid to children with frequent colds.

In the latter case, it is necessary to take preventive measures and try to reduce the number of SARS.

Juvenile idiopathic arthritis has not been fully studied yet, but sometimes spontaneous self-healing cases are recorded. But experienced rheumatologists do not advise to hope for such a miracle and to conduct all the recommended treatment to protect their child from negative consequences.

Symptoms and forms

Symptoms of juvenile idiopathic arthritis are closely related to its forms. According to the International Association of Rheumatology, there are 6 forms of this disease. For all types of arthritis is characterized by limited movement in the joints, especially in the morning after sleep.

At the age of 3 to 5 years, children can develop systemic idiopathic juvenile arthritis. Inflammatory process can affect both one and the whole group of joints. This form of the disease complicates the work of internal organs.

In children, pancreas and liver enlargement, pneumonia, pericarditis are observed.

The main symptoms are acute pain in the joints, a significant increase in body temperature, a feeling of aches in all organs of movement, edema on the joints.

The rheumatoid form means that the disease progresses, lasts for more than six months and the child suffers more than 5 joints.

The disease is more often recorded in adolescent girls. To characteristic rheumatoid symptoms in the form of painful feelings fast fatigue and anemia are attached.

The oligoarticular form of idiopathic juvenile arthritis involves a lesion of not more than 4 joints. Moderate pain accompanied by inflammation of the iris. The last symptom is especially important, because without proper treatment the patient develops glaucoma or cataract.

In children with psoriatic arthritis, deformities of the nails and diffuse edema of the fingers are observed. The disease develops against a background of skin disease of psoriasis.

Boys older than 8 years are more likely to enter arthritic arthritis. Inflammation is localized at the joints of tendons and bones.

Affected lower parts of the spine, knees, ankles, sacroiliac joints.

Treatment

Unfortunately, to date there is no single methodology that would guarantee the full recovery of the child.

Depending on the form and stage of the disease, symptomatic treatment is carried out aimed at improving the quality of life of the patient and preventing the aggravation of pathology.

Doctors use drugs to eliminate pain, relieve inflammation, support joints and other internal organs prone to damage.

Complex treatment should be developed with the participation of specialists such as a surgeon, orthopedist, rheumatologist, physiotherapist and ophthalmologist.

Visiting the last doctor plays a special role, because sometimes arthritis leads to a complete loss of vision. If there are indications, surgical treatment may be offered.

The operation is done only in extremely difficult cases, when it is required to install artificial prostheses on the knee and hip joints.

Effects

Some consequences for children have already been mentioned above (blindness, disruption of internal organs). In this case, one of the most serious complications is called secondary amyloidosis.

The development of this deviation leads to a disruption in the exchange of proteins and the deposition of amyloids in the tissues of the body. This substance is not excreted and displaces healthy cells.

Therefore, it is so important to pay attention to the alarming symptoms and seek help from specialists in time.
A source: http://LechimDetok.ru/ortopediya/yuvenilnyj-idiopaticheskij-artrit-u-detej-7344.html

Idiopathic Juvenile Arthritis: Symptoms and Treatment of a Child

Juvenile idiopathic arthritis is a collective term that is used to identify several different forms of childhood arthritis, similar in their symptoms and nature of occurrence.

For each form is characterized by joint damage and the development of the inflammatory process, the child thus suffers not only from severe pain in joints, but also from other symptoms of an acute infectious disease - nausea, vomiting, fever, headaches, a sharp deterioration in the overall state of health.

Why does juvenile arthritis develop?

At the moment it is not established, under the influence of what factors the disease begins to progress.

For a long time it was believed that the hereditary predisposition and the social conditions in which the child lives are decisive.

But this hypothesis has no official scientific confirmation.

The risk group includes children who:

• There are relatives who have any form of arthritis diagnosed;
• The child is prone to frequent colds.

In the first case, it is necessary to carry out all possible preventive measures to prevent the development of the disease. If the child's immunity is weakened, then one should steadfastly monitor his daily routine, nutrition and hygiene.

The organism of the child on the one hand is very vulnerable, since it is not yet fully formed and the immune system is weak.

But on the other hand, metabolic processes occur faster in it, it is easier to restore and therefore there are cases when juvenile idiopathic arthritis passes by itself.

Believe in a safe outcome is necessary, but do not forget about the prevention and treatment of the disease.

Classification and symptoms

The International Association of Rheumatology distinguishes six main types of juvenile arthritis: Clinical picture may be different depending on the form of the disease, but one symptom is typical for any kind of juvenile arthritis.

This is the morning stiffness of the joints, sometimes such that the child can not get out of bed before noon.

Successful treatment of the disease is impossible without an accurate definition of which form of juvenile arthritis the child suffers.

Systemic arthritis

With this form of pediatric arthritis, inflammation can develop in one joint or at once in several. Affected limbs are very swollen, the child experiences acute pain, body aches, weakness, body temperature, as a rule, increased.

Complications include pericarditis, lesions of the liver and spleen, pneumonia.

Systemic juvenile arthritis affects mainly children aged 3 to 5 years, both boys and girls.

At the initial stage, anemia develops, then the child's growth stops, the structure changes bones and ligaments, they are weakened, the latest ones are affected by internal organs - the heart, lungs, liver.

Rheumatoid juvenile arthritis

Such a diagnosis is made if the inflammation spreads to five or more joints, and also if the disease lasts more than six months. Suffer mainly girls aged 11 to 16 years.

Oligoarticular form of idiopathic arthritis

The main feature by which this form is differentiated from others is that no more than four joints are affected. The pain is not intense, but permanent, in the morning stiffness is noted, and often the iris of the eyeball is affected.

The main and most common complication is cataract or glaucoma, in severe cases leading to complete loss of vision.

Psoriatic Juvenile Arthritis

The main symptoms of this form of arthritis: swelling of the fingers and toes, deformation of the nail plates, iritis. On the skin appear rashes, characteristic of psoriasis, although this is psoriatic arthritis.

Enthesopathic Juvenile Arthritis

Enteite- an inflammation of the joint site, in which the bone and tendon connects. Affected usually lumbar spine, sacroiliac joints, knee joints, ankles.

This form is more often diagnosed in boys aged 7-8 years. Complications with this arthritis are psoriasis, iritis, ankylosing spondylitis.

Undifferentiated arthritis

There are cases when the child begins to develop arthritis, but his symptoms do not fall under any of the above listed species. In this case, the disease is comprehensively studied - it may be a new form, but for now it is undifferentiated arthritis.

Methods of diagnosis of juvenile arthritis

To diagnose idiopathic arthritis, children use the same methods as adults. Inflammation is confirmed by a blood test - the level of hemoglobin is lowered, and the level of leukocytes in the blood is increased. Radiography is mandatory. This study allows you to establish:

• The degree of periosteal growth;
• The presence of erosion and fusion of bone tissue;
• Enclosure of the epiphyses;
• Narrowing of the joint between the joints;
• Osteoporosis.

At the initial stage of development, radiography can not show all these signs, or they will be very weakly expressed. Therefore, it is necessary to conduct other laboratory tests. An extensive blood test allows you to determine:

1. Leukocytosis.
2. Increased ESR.
3. High concentration of CRP.
4. Positive rheumatoid factor - usually it is detected in 20% of patients.
5. ANAT - more often in girls with complications such as erect or oligoarthritis.

To prevent complications and start adequate treatment as early as possible, it is important to put a correct diagnosis at the initial stage of the disease development. The problem is that most of the characteristic symptoms for this or that type of juvenile arthritis appear as the disease progresses.

Therefore, constant visits to the doctor and conducting appropriate examinations are necessary. Juvenile arthritis has a chronic nature, the symptoms and clinical picture can vary.

Such a diagnosis, as juvenile juvenile idiopathic arthritis, is given only to children under 16 years of age, when symptoms of the disease are noted for more than six weeks in a row. Preliminary it is necessary to exclude all other pathologies, which can have similar symptoms and manifestations.

Treatment

There is no single method of treating this disease, since the nature of its origin and the features of the current are not yet fully understood. Treatment is conducted in two main directions:

1. Prevention of joint destruction;
2. Prevention of complications and spread of inflammation to other internal organs.

First and foremost, it is important to make the child's life as comfortable and full-fledged as possible, as peer as possible.

For this purpose, drugs are prescribed that eliminate pain syndrome and stop the inflammatory process.

If there is a deformation of the joints, then procedures are carried out for their restoration and preservation of mobility.

If the destruction is irreversible, endoprosthetics of the knee or hip joints are performed, with the damage of small joints of the hands and stop - arthroplasty.

Possible consequences of juvenile arthritis

The most common complication is the development of secondary amyloidosis.

Amyloidosis is a violation of protein metabolism in the child's body, as a result of which special substances - amyloids - are deposited in the joint tissues.

In the structure of cells they do not participate, but only displace healthy cells responsible for tissue growth.

Amyloidosis can not always be stopped. As a result, internal organs and bones change their structure and structure, lose functionality, often it leads to death.

On the contrary, it is noted that children who lead an active lifestyle suffer less from symptoms and exacerbations of the disease, the periods of remission are longer for them than for those who adhere to the bed mode.

But to avoid injury, traumatic sports should be avoided, swimming, gymnastics, and bicycles should be preferred. In the period of remission, it is recommended to have a sanatorium treatment, wearing orthoses, and, if necessary, consulting a psychologist.

A source: http://sustav.info/bolezni/arthritis/idiopaticheskij-yuvenilnyj-artrit-simptomy-i-lechenie-rebenka.html

Juvenile idiopathic arthritis

In fact, juvenile idiopathic arthritis is a combination of several forms of chronic childhood arthritis, which have a similar symptomatology.

Each of the forms when affected causes joints and becomes a source of inflammatory processes in connective tissues. This is accompanied by severe pain and general deterioration of the child.

This disease corresponds to the code M08 for ICD-10 (juvenile arthritis).

Causes of the disease

At the moment there are no officially established causes of the disease, but more often than not development is observed because of hereditary factors, and it is also believed that the great influence is bad ecology.

That's why most often sick are those children who live in contaminated cities. But so far these are only assumptions, and the details are still being studied.

The child is at risk if a similar disease has been detected in one of his close relatives or frequent colds are observed.

In the firstit is important to conduct appropriate prevention.

In the second- find out the cause of permanent ailments and maximize the child from contact with dirty objects, so as not to provoke an infectious disease again.

Despite the age, the children's body is strong enough, and therefore it happens that the disease passes completely spontaneously. But do not rely on it, because in other cases serious problems arise, the recovery after which may take years.

Symptoms and forms of juvenile idiopathic arthritis

The International Association of Rheumatology has established six different forms of juvenile idiopathic arthritis.

Each of them is characterized by a morning stiffness in the joints, which lasts no less than an hour, sometimes prolonging until noon.

Despite the similarity of the common symptoms, it is important for an effective therapy to accurately diagnose which of the forms the patient is sick.

Systemic Juvenile Idiopathic Arthritis

This form is characterized by inflammatory processes that can spread both to one joint and to a whole group. In this case, acute pain occurs, and the affected joints swell.

Often a patient may experience fever, a fever of the whole body, a feeling of aches and weakness.

The disease can provoke the development of pericarditis, pneumonia, enlargement of the liver and spleen.

The disease most often occurs in children aged 3 to 5 years, regardless of sex. First of all, anemia appears, after growth slows down, bones become weaker, and at later stages the lungs and liver work are disrupted.

Rheumatoid form

This type is diagnosed if the patient has a disease for more than six months, and if it covers 5 or more joints.

It is most common among teenage girls.

Among the characteristic symptoms are rapid fatigue by the second half of the day, anemia, pain, periodically recurring in the area of ​​damaged joints.

Oligoarticular idiopathic arthritis

Usually, with this form, no more than four joints become inflamed at the same time. It is for this reason that diagnostics is most often performed.

In addition, there are mild but prolonged pains in the joints, accompanied by stiffness in the morning and inflammation of the iris.

Due to oligoarticular idiopathic arthritis, the patient may develop glaucoma or cataract. In extreme cases, complete loss of vision is possible.

Psoriatic arthritis

The main feature is the appearance on the skin of psoriasis. Diffuse swelling of the fingers and deformation of the nails are possible. Children also are able to develop irit.

Enteroscopic arthritis

Entezit is an inflammation that passes through the joints of the tendons with the bone. Most often this form affects boys from 8 years old.

Inflammation develops in the lower region of the back, in the knees, in the sacroiliac joints and at the ankles.

It can develop psoriasis (not to be confused with psoriatic arthritis), iritis and ankylosing spondylitis.

Undifferentiated arthritis

When the disease proceeds in a special way, namely: does not correspond to the symptoms of any of the above categories, it refers to undifferentiated arthritis and requires careful study by all possible ways.

Diagnosis of the disease

Identification of idiopathic arthritis in children is not very different from diagnosing an ailment in an adult.

The main signs of inflammation are anemia and an increased concentration of leukocytes in the blood.

The main method of diagnosis is X-ray examination. It provides an opportunity to identify:

• periosteal growths;
• erosion;
• ankylosis;
• narrowing of the gaps between the joints;
• infection of the epiphyses;
• osteoporosis.

In the early stages, radiology may not show these signs, so the most accurate are the laboratory data that can determine:

1. leukocytosis;
2. excess of the ESR norm;
3. increased concentration of CRP;
4. positive RF (more often only in 20% of patients);
5. ANAT (usually in girls with an ovette or oligoarthritis).

The diagnosis of juvenile idiopathic arthritis is given to children under sixteen years old, whose symptoms have been noticed for more than six weeks.

Also the main condition is the exclusion of all other diseases that are capable of provoking such pathologies.

It can be said that juvenile idiopathic arthritis in children includes all types of arthritis, which have a long development, but are not distinguished by characteristic clear causes of occurrence.

Treatment of pathology

Since the study of this disease is still at the research stage, there was no single treatment method.

Therapy is aimed at preventing the destruction of joints and other internal organs with unexpected remissions of the disease.

It is also important to make the child's life as full as possible so that he does not feel dependent on the ailment.

Thus, the main part of the drugs used in the treatment, is aimed at suppressing pain and inflammation of the joints.

In some cases, therapy is prescribed measures that are aimed at preventing the formation of deformities in the joints and maintaining their functionality.

In extreme cases, surgical intervention is required. Patients are being replaced with knee and hip joint prostheses. Also, the brushes and feet are restored surgically after large deformations.

Consequences of juvenile polyarticular arthritis

One of the most common consequences is the occurrence of secondary amyloidosis.

Amyloidosis- a violation of protein metabolism in the child's body, in which amyloids are deposited in joints.

These are substances that do not take part in the metabolism, but are only deposited in tissues. At the same time, they displace healthy cells, which, unlike amyloids, participate in the system of cell structure. Thus, the organs destruct and lose their functions.

Unfortunately, after such a complication, there are also lethal cases.

Doing sports during illness

The main goal with this diagnosis is to provide the child with a normal daily life so that he does not differ in any way from his peers.

As you know, the main activity of children is sports, both amateur and professional.

Proceeding from this, sports for children with a diagnosis of "polyarticular arthritis" are allowed, since even small physical stress will be a better option than a psychological trauma.

It is not recommended to choose dangerous sports, it is best to give preference to occupations with a minimum risk of damage. Excellent option - swimming or biking. In addition, they will have a positive effect on the development of joints.

Rehabilitation

After such a disease as juvenile polyarticular arthritis, it is important to make every effort to avoid the recurrence of the disease.

To this end, during the period of remission, it is recommended to send the child to a sanatorium-and-spa treatment. To restore after deformations, orthoses are prescribed.

These are orthopedic adaptations, dressing before bedtime. Sometimes a child needs a visit to a psychologist.

A source: http://MedOtvet.com/arthritis/uvenilnyi-idiopaticheskii-artrit.html

Idiopathic arthritis - symptoms and treatment

Children are the most valuable and valuable thing that we have. And the health of the child excites every parent. Among the numerous childhood diseases, one of the most insidious and inexplicable is arthritis of unknown etiology.

Idiopathic arthritis is an inflammation of joints of unknown origin.

In medical terminology, idiopathic arthritis is referred to pediatric diseases and is defined as juvenile idiopathic arthritis.

This suggests that this disease is detected in children and adolescents under 16 years. JIA is most often seen at the age of two.

Causes of the disease

Despite the fact that the JIA is a fairly common disease, the reasons for its occurrence and development are not completely known.

Possible factors in the development of this disease are:

• infectious diseases;
• the violation of immune processes with the subsequent development of autoimmune reactions;
• stressful conditions;
• use of protein preparations;
• general hypothermia of the body;
• injury;
• immunogenetic predisposition.

In the aggregate of predisposing factors, the patient develops hypersensitivity to various stimuli, as a result of which a complex immune process is triggered in the body, which leads to progression of the disease. Appearing in childhood idiopathic arthritis continues to develop and turns into chronic rheumatoid arthritis in adulthood.

Mechanism of disease development

Inflammatory process as much as possible affects the synovial membrane of the joints. The early stage of the disease is characterized by a "nonspecific" inflammatory response in the joints to various stimuli.

If the child is genetically predisposed to arthritis, then the pathological changes of the synovial cells occur in the joint.

As a result of the inflammatory reaction, specific immune cells (T- and B-lymphocytes, dendritic cells) are activated. forming an independent lymphoid organ, cells of which actively begin to synthesize antibodies to altered synovial cells.

Aggressive autoantibodies and the resulting immune complexes activate the immune response and Increase the inflammatory process inside the joint more, which leads to further tissue damage the joint. In response to the formed immune complexes, plasma synovial cells also begin to produce antibodies that are called rheumatoid factors (RF).

Analyzing the mechanism of the development of the disease, we can say with confidence that the basis is an autoimmune reaction of the organism.

This is confirmed by the evidence found in the analyzes:

1. various autoantibodies;
2. rheumatoid factors;
3. lymphocytes sensitized to connective tissue components;
4. circulating and fixed in tissues immune complexes;
5. polyclonal activation of B-lymphocyte is detected; lymphocytes specific to other antigens are activated by non-specific T-independent antigens.
6. the production of cytokines (information molecules that talk about the activity of immunocompetent cells) is disrupted;
7. the production of adhesion molecules is disrupted.

Adhesion molecules are membrane proteins that participate in the binding of cells among themselves, as well as with the extracellular matrix.

As a result of the progression of autoimmune reaction processes, the synovial shell, soft tissues of the joints, cartilage, subchondral bone, bone tissue of the epiphyses and internal bodies. The disease develops very quickly within three months and can last more than 6 weeks, after which the remission period begins.

Symptoms

• a sharp increase in temperature to 38-40 degrees;
• rashes on the skin;
• swelling of the joints;
• soreness of the joints;
• soreness of the cervical spine;
• pain in the temporomandibular joints is possible;
• slight stiff neck;
• limitation of mobility of joints.

If the symptoms continue to manifest for 6 weeks, you should always contact a rheumatologist.

With symptomatic treatment, skin rashes and high fever pass, but arthritis already remains for life.

Although there are also cases when alternating exacerbations and remissions of the disease for 3-5 years, suddenly abruptly stop. Doctors explain this by saying that the immune system is "ripe".

And if the correct treatment was performed during periods of exacerbation of the disease, the child's growth processes are restored within 2-3 years.

Types of the disease

Depending on the number of affected joints and the degree of involvement of internal organs, there are 3 types of idiopathic arthritis.

Oligoarthritis

It is observed five times more often in girls than in boys. The disease manifests itself in 2 years of age, affects up to 4 joints, mostly large joints and asymmetrically.

Polyarthritis

Also occurs more often in girls than in boys, but 3 times more often. The disease can occur at any age. In this case, more than 5 symmetrical joints, including small ones, are affected.

Systemic Juvenile Idiopathic Arthritis

Equally affects girls and boys. It can also appear at any age.

For this type of systemic manifestations are characteristic:

1. high temperature (39-40 degrees) for 2 weeks
2. polymorphic, transient, volatile eruptions;
3. lymphadenopathy (an increase in regional lymph nodes);
4. hepatomegaly (enlargement of the liver);
5. splenomegaly (enlarged spleen);
6. pericarditis;
7. pleurisy;
8. delayed joint syndrome (the manifestation of joint pain and changes may lag behind the remaining symptoms from several weeks to several years).

Diagnostics

For differential diagnosis, the following studies are recommended:

• visual inspection of skin;
• palpation of the joints (soreness in the compression of the hand in the fist);
• a general blood test (there is an increase in ESR up to 40-60 mm / h, anemia is present);
• sowing biological media for the detection of pathogenic microflora and its sensitivity to drugs;
• immunological studies;
• bone marrow biopsy (to exclude oncohematological diseases);
• serological methods for the exclusion of other infections;
• computed tomography (or MRI) of the thoracic cavity;
• computed tomography (or MRI) of the abdominal cavity;
• computed tomography of the brain;
• endoscopic studies;
• procalcitonin test (for the exclusion of sepsis or a local inflammatory process).

Treatment of juvenile idiopathic arthritis

The treatment is aimed at preventing the destruction of joints and internal organs, suppression of joint and systemic inflammation, joint rehabilitation. Depending on the type of arthritis, appropriate treatment is selected.

In the treatment of juvenile idiopathic arthritis, complex therapy is used:

1. Diet - table number 10 - a sharp restriction of table salt and enrichment of the diet with potassium.

proteins within the lower limit of physiological norm, moderate restriction of fat and carbohydrates. Food is prepared without salt, specially baked salt-free bread.

2. The use of NSAIDs (non-steroidal anti-inflammatory drugs)

3. Physiotherapy (pulse therapy with methylprednisolone)

4. Intraarticular injections (triamcinolone hexacetonide)

5. Oral glucocorticoids

6. Parenteral glucocorticoids

7. Intravenous immunoglobulin

8. Immunosuppressive therapy

9. The appointment of methotrexate in small doses once a week

10. The appointment of biologically active drugs, for example, actemra (the drug is effective in the treatment of the systemic form of JIA)

11. Observations from an ophthalmologist

12. Autologous stem cell transplantation in severe forms of JIA

13. Orthopedic surgery

14. Rehabilitation activities

Forecasts

Juvenile idiopathic arthritis can proceed in different ways, depending on its form. One of the concomitant complications is uveitis, iridocyclitis, clouding of the lens of the eye and even blindness. But with timely diagnosis and appropriate treatment, these effects can be avoided.

Despite the fact that this is a chronic disease, with properly selected treatment and systematic observation of rheumatologists, cardiologists, orthopedists and ophthalmologists, possible prolonged remission. Although with frequent recurrences of the systemic form of idiopathic arthritis, an early disability is possible (no more than 10% of cases).

A source: http://TvoyAybolit.ru/idiopaticheskij-artrit-simptomy-i-lechenie.html

Effective methods of treatment of juvenile arthritis in children

Juvenile arthritis (SA) is rare and is diagnosed in children under 16 years, often from one to four years.

Chronic inflammatory rheumatoid diseases of joints are more common for girls.

To suspect signs of arthritis in a small child is difficult, because the swelling of the joint is not always noticeable.

Children can not complain of pain, they are capricious and refuse to eat.

If they begin to limp or do not give pens, do not want to play, are chained in the morning - this can be regarded as the first signs of the disease.

Juvenile arthritis is most often diagnosed at the preschool age

Possible causes and consequences of arthritis development

As a result of many years of research, scientists were unable to develop a single hypothesis explaining the etiology of the disease.

Earlier juvenile arthritis in children was associated with the influence of Epstein-Barr viruses, streptococci, staphylococci and other infectious agents.

However, this connection was not confirmed by laboratory and clinical tests.

It is believed that juvenile rheumatoid arthritis in children is a polyethological disease. Do not exclude the presence of genetic predisposition, the characteristics of the immune system, the effect of the transferred viral infections.

Juvenile chronic arthritis slows the physical development of children: disrupts the growth of the joints in the affected area, the lower jaw remains underdeveloped, the fingers are too short or long.

YA in children in the late stages becomes the cause of eye damage: uevita, mild conjunctivitis, episcleritis, dry keratoconjunctivitis.

Juvenile rheumatoid arthritis causes inflammation of the synovial joints

Readers often study together with this material:

• How to recognize Still's disease in adults and children
• Proper nutrition in the fight against the development of joint arthritis

loading…

By the nature of the lesion and the degree of spread, juvenile arthritis happens:

1. Oligosuscular chronic rheumatoid (polyarticular). It occurs in boys under 5 years in 50% of all cases of arthritis. The first six months affect 5 or more joints, primarily large joints (knees), there is no fever. There may be problems with eyesight. Prolonged or complete remission can occur after long-term treatment (3-4 years).
2. Juvenile spondylitis. It occurs in adolescents 10-16 liters (16%). It is recognized by the pain symptoms and lesions of the joints of the lower extremities.
3. Systemic acute JIA accompanied by skin rashes, fever and temperature. It occurs in preschool children, adolescents (10%) and rarely in adults.
4. Polyarticular JIA with muscle and tendon damage. It is rare and more common in girls (5%). The treatment uses powerful anti-inflammatory drugs and immunosuppressants.
5. Psoriartrichesky arthritis on the background of psoriasis - an inflammatory skin disease with scaly patches on the skin in the form of bright red or pink rounded papules. Eruptions precede arthritis or appear with the development of inflammation.

The editor has found for you two more interesting materials:

• Massage and folk remedies for the treatment of arthritis of the fingers
• Methods of pain blockade in periarthritis of joints

There are rheumatoid seronegative juvenile arthritis and seropositive.When seropositive arthritis is detected in the blood rheumatoid factor, with seronegative it is absent.

Symptoms of seropositive juvenile rheumatoid arthritis in children are manifested:

1. slow start;
2. presence in the blood of the RF;
3. at the initial stage, the defeat of small joints, later - large ones;
4. morning stiffness, depending on the stage of the inflammatory process, lasting for 15 minutes or several hours;
5. intensified sweating;
6. extra-articular lesions: rheumatoid nodules, enlargement of the liver, lymph nodes, spleen.
7. lung damage, dyspnea;
8. coarsening of the voice in the defeat of the ligamentous ligaments.

Rheumatoid seronegative arthritis begins with acute fever, a violation of the general condition. There is no RF in the blood. The initial stage is characterized by the defeat of one large joint, for example, a knee or several smaller joints.

Seronegative arthritis affects small joints

Later, arthritis affects the small joints of the feet or brushes. Stiffness in the morning and the appearance of rheumatoid nodules are not noted. Less common are viscera and an increase in LU. Seronegative arthritis can pass into seropositive.

In children, seronegative juvenile arthritis is more common than seropositive. Suffer children after 5 years, often sick girls.

Treatment in children

Treatment of juvenile rheumatoid arthritis in children is carried out taking into account the general condition of the joints and the whole organism, the state of bone and cartilaginous tissue, the nature of the immunological pathology.

The basic drugs of drug therapy are NSAIDs and glucocorticoids. Of the NSAIDs are applied: Naproxen, Ibuprofen, Indomethacin, Diclofenac, etc. Aspirin try not to apply, so as not to cause serious complications.

Corticosteroids are prescribed by short courses, often administered intra-articularly, especially with severe inflammation of several joints with restricted movement.

Methotrexate - the basic drug in the treatment of juvenile arthritis

Immunotherapy is carried out by dropwise intravenous injection of Intraglobin, Pentaglobin, Sandoglobulin at a rate of 10-20 drops / min. Gradually increase the rate of administration to 2 ml / min. Repeat infusion therapy every month (if necessary).

Rheumatoid uvites with acute and seropositive forms YURALECHAT rheumatologist and oculist with cytostatics (Cyclophosphamide, etc.).

In recent years, as part of a comprehensive therapy, treatment with biological products has been introduced:

• TNF blockers (etanercept, adalimumab, infliximab) in combination with methotrexate;
• blocker CTL4Ig (Abatacept);
• blockers Interleukin 1 (Anakinar and Kanakinumab) and Interleukin 6 (Tocilizumab).

Rheumatoid arthritis with untimely treatment can lead to disability

Endoprosthetics

With a significant limitation of mobility in the joints, surgical treatment is performed: endoprosthetics of the knee or hip joint. It is also practiced the rapid removal of muscle contractures.

Rehabilitation and prognosis

During rehabilitation, physiotherapy, exercise therapy, massage and non-traditional folk methods of treatment are performed. Much attention is paid to the nutrition of the child.When carrying out complex therapy, the prognosis for juvenile arthritis in children is favorable, with a long-term remission without relapses.

During the rehabilitation period, it is necessary to maintain the active lifestyle of the child, because vigorous children easily tolerate the course of the disease and can avoid complications of arthritis

Treatment of JRA should begin with the first symptoms, so as not to lose mobility of the joints. Adequate treatment and diet will help to avoid deformation and destruction of joints.

A source: http://SustavInfo.com/bolezni/artrit/simptomy-i-lechenie-yuvenilnogo-artrita/

Idiopathic arthritis in children: symptoms and treatment

Rheumatic diseases in childhood are relatively infrequent.

However, having arisen, they can occur in severe forms and lead to disability of the child.

One of the most famous and common rheumatic diseases is juvenile idiopathic arthritis, or JIA.

Juvenile arthritis

Juvenile idiopathic arthritis is known to most doctors as juvenile rheumatoid arthritis.

So he was designated earlier in many manuals on rheumatology.

However, according to modern terminology, the definition of "idiopathic" is correct, and the concept itself includes a group of similar diseases.

The term "juvenile" suggests that this is a disease exclusively of childhood and adolescence, and "idiopathic" indicates the absence of a specific causative factor.

Classification

In modern rheumatology, there are several classifications of juvenile idiopathic arthritis. The most famous among them are the following:

• American College of Rheumatology, or ACR.
• European league against rheumatism, or EULAR.
• International League of Rheumatology Associations, or ILAR.

In the practice of a physician, it is most convenient to use the ILAR classification. In accordance with her, the following variants of juvenile idiopathic arthritis are distinguished:

1. System.
2. Oligoarticular.
3. Polyarticular.
4. Psoriatic.
5. Entwined.
6. Uncertain.

System option

Systemic variant of JIA is manifested in children with persistent fever and erythematous rash, which is characterized by volatility (appearance and disappearance in various places). In addition, this form of the disease affects all body systems and can manifest itself with the following symptoms:

• Generalized lymphadenopathy - lymph node involvement throughout the body.
• Hepatomegaly - increased liver size.
• Splenomegaly - an increase in the spleen.
• Serositis - an inflammation of serous membranes in various organs. Especially dangerous is inflammation in the heart bag - the pericardium and pleura that covers the lungs.

These signs may be present all together or manifest separately. Inflammation of the joints with this form is of a generalized nature. The system variant refers to rather heavy forms of JIA.

Oligoarticular variant

From the title it is evident that in this case only a few joints are damaged - usually from one to five. Oligoarticular JIA is typical for children, it almost never occurs in adults.

There are two types of this form of juvenile idiopathic arthritis:

1. Persistent.
2. Progressive.

In the first case, the number of affected joints throughout the disease does not exceed four. In the second - after half a year 5 or more joints are involved in the pathological process.

Polyarticular variant

The polyarticular variant is characterized by the defeat of five or more joints during the first six months of the disease. It is considered a more severe form, in comparison with the oligoarticular lesion.

In the diagnosis, two subtypes of the polyarticular variant are distinguished - depending on the values ​​of the rheumatoid factor. The disease can be positive or negative in this indicator. A positive subtype is more common.

Psoriatic variant

This is a fairly severe form of the disease, developing against the background of skin lesions - psoriasis.

It can be manifested by inflammation of the joints and specific plaques on the skin. However, dermatological symptoms are not always present.

To diagnose this option, a combination of arthritis with characteristic nail changes, cases of psoriasis in first-degree relatives or dactylitis (inflammation in the fingers) is sufficient.

Enthrite variant

The second name of this form is enthesite-associated polyarthritis. Entezit is an inflammatory process in the attachment zone of tendons and ligaments. Pain in this area is called enthesopathy.

With this version of juvenile idiopathic arthritis, the joints of the lower extremities and the spine are mostly affected. Enthesitis is characterized by painful sensations in the crests of the iliac bones, sacrum, patella, arches of the feet.

Entezit aggravated after physical exertion, overwork, hypothermia. In this case, the symptoms of joint inflammation can also increase. For this variant of the disease, the development of periarticular muscular atrophy is typical.

The diagnosis is established on the basis of a combination of arthritis with enthesitis or one of these pathologies with the following symptoms:

• Pain in the back is inflammatory.
• Sensitivity or soreness of the sacroiliac joints.
• Detection in the blood of HLA-B27, characteristic of many autoimmune diseases.
• Weighed down family history (cases of similar diseases in close relatives).

Undefined version

It includes all other arthritis. As a rule, these are inflammatory processes in joints in children, lasting not less than six months. But their cause remains undetected.

The clinical manifestations of other arthritis do not allow attributing them to any specific variant of the JIA. Sometimes they are characterized by signs of two or more forms.

Diagnostics

Diagnosis of JIA in children is not always simple. A careful examination of the child is required, which excludes other pathologies - posttraumatic and reactive arthritis, autoimmune diseases (systemic lupus erythematosus, nonspecific ulcerative colitis), as well as rare genetic syndromes.

As a rule, the first doctor of such a patient becomes a pediatrician, who later sends it to a children's rheumatologist. Primary examination includes:

1. General tests of blood and urine.
2. Biochemical examination of blood with detection of markers of inflammation.
3. Conducting a rheumatic test.
4. Definition of rheumatoid factor.
5. HLA-typing.
6. X-ray or ultrasound examination of joints.

Treatment

Juvenile idiopathic arthritis is a serious disease. It can not be cured by drinking the course of some single tablets. The therapeutic approach must necessarily be comprehensive.

In the treatment of JIA, two main methods are distinguished:

• medicamentous;
• non-pharmacological.

They do not exist separately, but complement each other. It is important to strictly follow the prescriptions of the rheumatologist and follow all his instructions to slow the development of the disease and avoid disabling children.

Medication method

The most common drugs that are used for JIA therapy are non-steroidal anti-inflammatory (NSAIDs) and glucocorticoid drugs (HS).

The main goal of the treatment is to relieve the symptoms of inflammation and reduce pain. This also restores the function of the affected joints.

However, it is impossible to stop the process of destruction of joints with NSAIDs and HS, as well as to prevent disability of a small patient.

Juvenile idiopathic arthritis sometimes requires the holding of pulse therapy in children - treatment of large doses of glucocorticoids. As a rule, such a need arises in the systemic variant of the disease with the development of polyserositis.

But the basis of treatment of JIA still remains a constant intake of glucocorticoids or immunosuppressors in small doses for a long time.

Non-steroidal anti-inflammatory drugs are used as an auxiliary treatment in children, for rapid relief of unpleasant symptoms.

Non-pharmacological method

Idiopathic arthritis is a disease with a progressive course. Therefore, it is important to direct all the forces of the organism to fight it. Do not neglect such factors as diet and treatment or exercise.

When the disease is in a phase of exacerbation, the patient's motor activity should be limited. However, complete immobilization of the joints is contraindicated in order to avoid the development of contractures and muscle atrophy.

Food should contain a sufficient amount of vitamin D3 and calcium, since their lack can aggravate the disease. It is also important that with the food in the child's body the right amount of protein is supplied.

Without physical therapy, it is almost impossible to restore the function of the affected joint even after taking the strongest medications. However, all exercises are selected only by a doctor in accordance with the phase of the disease and the presence of complications.

JIA in children is a serious and unpleasant disease. But in close cooperation with a rheumatologist with a disease it usually manages to cope.

A source: http://MoySkelet.ru/bolezni/artrit/idiopaticheskij-artrit-u-detej-simptomy-i-lechenie.html