Juvenile rheumatoid arthritis is a long-term joint inflammation (arthritis) is similar to rheumatoid of arthritis in adults, but it starts before the age of 16 year.
The cause of the disease is unknown. Hereditary factors may increase the risk of disease.
Symptoms
In about 40% of children disease affects only a few joints, and another 40% is affecting many joints. The remaining 20% of patients develop a systemic disease that affects the entire body, not just the joints, and can also be seen with fever, a condition called Still's disease.
Inflammation that affects only a few joints usually occurs before the age of four years (usually girls) or after eight (usually boys). The affected joint is painful, swollen (edematous), and stiff, and usually hit his knee, ankle and elbow. Sometimes, they may be more affected by two other joints such as the big toe, wrist, or TMJ, which are stiff and swollen. Symptoms resulting from the joint may not last long, or you can go back and pull.
Girls have more inflammation of the iris (iris) and ciliary body in the anterior chamber (chronic iridocyclitis), which does not always cause symptoms and are discovered only target search. Inflammation of the ciliary body can cause blindness, because the children have to specifically browse the circumstances of this possibility in the case of irodociklitisa treated immediately.
Inflammation of multiple joints can occur at any age and affects equally boys and girls. Pain, swelling and stiffness may begin gradually or suddenly. The joints that are usually affected are the knee, ankle, wrist and elbow. Later joint inflammation occurs both hands, neck, temporomandibular joint, and may be affected hips. The inflammation is usually symmetrical, and affects some joints on both sides of the body, for example. both knees and both hips.
Systemic juvenile rheumatoid arthritis affects boys and girls equally. The temperature is variable (intermittent), usually higher in the evening (often 39.5 ° C or higher), and then rapidly returned to normal.During fever, the child has a sense of serious illness. Surface, sitnotačkasti pink rash mainly on the trunk and upper parts of the arms and legs, there is a short time (often at night), migrate (occurring in different places), disappears and can occur. The spleen and some lymph nodes may be increased. Pain, swelling and stiffness occurs last.
Every juvenile rheumatoid type of arthritis can hinder growth. When the disease interferes with the growth tempromandibularnog joint may be poorly developed chin (micrognathia).
Rheumatoid factor, an antibody that is often found in the serum of adults with rheumatoid arthritis, is rarely found in children with juvenile rheumatoid arthritis. Rheumatoid factor is most commonly found in girls where the disease spread to multiple joints (polyarticular form).
Prognosis and treatment
Symptoms of juvenile rheumatoid arthritis completely disappear under the influence of drugs in about 75% of children. The prognosis is worse in those who have the disease spread to more joints which are found in rheumatoid factor.
High doses of acetylsalicylic acid (aspirin) can usually reduce the pain and inflammation of the joints. Other non-steroidal anti-inflammatory drugs, eg. tolmetin and naproxen, are often used instead of aspirin because of the risk of Reye's syndrome.
Children may be given corticosteroids by mouth if the disease is severe and if it affected the whole body, but steroids inhibit the growth of the child and the need to avoid use if possible. Corticosteroids may be administered directly to affected joints to reduce inflammation locally. A child who does not respond to aspirin or other anti-inflammatory drugs can be injected with the preparation of gold. Penicillamine, methotrexate and hidroksihlorokin can be applied when the gold salts no effect or cause side effects.
Exercises keep your joints movable and protect them from development stiffness. The splint can prevent joint remains fixed in position unsuitable.
Eyes are reviewed every six months to rule out inflammation of the iris (iris) and ciliary body in the anterior chamber. Inflammation is treated with corticosteroid eye drops or eye ointment that open wide (dilate) the pupil. Sometimes it is necessary to conduct eye surgery.
The cause of the disease is unknown. Hereditary factors may increase the risk of disease.
Symptoms
In about 40% of children disease affects only a few joints, and another 40% is affecting many joints. The remaining 20% of patients develop a systemic disease that affects the entire body, not just the joints, and can also be seen with fever, a condition called Still's disease.
Inflammation that affects only a few joints usually occurs before the age of four years (usually girls) or after eight (usually boys). The affected joint is painful, swollen (edematous), and stiff, and usually hit his knee, ankle and elbow. Sometimes, they may be more affected by two other joints such as the big toe, wrist, or TMJ, which are stiff and swollen. Symptoms resulting from the joint may not last long, or you can go back and pull.
Girls have more inflammation of the iris (iris) and ciliary body in the anterior chamber (chronic iridocyclitis), which does not always cause symptoms and are discovered only target search. Inflammation of the ciliary body can cause blindness, because the children have to specifically browse the circumstances of this possibility in the case of irodociklitisa treated immediately.
Inflammation of multiple joints can occur at any age and affects equally boys and girls. Pain, swelling and stiffness may begin gradually or suddenly. The joints that are usually affected are the knee, ankle, wrist and elbow. Later joint inflammation occurs both hands, neck, temporomandibular joint, and may be affected hips. The inflammation is usually symmetrical, and affects some joints on both sides of the body, for example. both knees and both hips.
Systemic juvenile rheumatoid arthritis affects boys and girls equally. The temperature is variable (intermittent), usually higher in the evening (often 39.5 ° C or higher), and then rapidly returned to normal.During fever, the child has a sense of serious illness. Surface, sitnotačkasti pink rash mainly on the trunk and upper parts of the arms and legs, there is a short time (often at night), migrate (occurring in different places), disappears and can occur. The spleen and some lymph nodes may be increased. Pain, swelling and stiffness occurs last.
Every juvenile rheumatoid type of arthritis can hinder growth. When the disease interferes with the growth tempromandibularnog joint may be poorly developed chin (micrognathia).
Rheumatoid factor, an antibody that is often found in the serum of adults with rheumatoid arthritis, is rarely found in children with juvenile rheumatoid arthritis. Rheumatoid factor is most commonly found in girls where the disease spread to multiple joints (polyarticular form).
Prognosis and treatment
Symptoms of juvenile rheumatoid arthritis completely disappear under the influence of drugs in about 75% of children. The prognosis is worse in those who have the disease spread to more joints which are found in rheumatoid factor.
High doses of acetylsalicylic acid (aspirin) can usually reduce the pain and inflammation of the joints. Other non-steroidal anti-inflammatory drugs, eg. tolmetin and naproxen, are often used instead of aspirin because of the risk of Reye's syndrome.
Children may be given corticosteroids by mouth if the disease is severe and if it affected the whole body, but steroids inhibit the growth of the child and the need to avoid use if possible. Corticosteroids may be administered directly to affected joints to reduce inflammation locally. A child who does not respond to aspirin or other anti-inflammatory drugs can be injected with the preparation of gold. Penicillamine, methotrexate and hidroksihlorokin can be applied when the gold salts no effect or cause side effects.
Exercises keep your joints movable and protect them from development stiffness. The splint can prevent joint remains fixed in position unsuitable.
Eyes are reviewed every six months to rule out inflammation of the iris (iris) and ciliary body in the anterior chamber. Inflammation is treated with corticosteroid eye drops or eye ointment that open wide (dilate) the pupil. Sometimes it is necessary to conduct eye surgery.
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