Juvenile rheumatoid arthritis: symptoms, diagnosis and treatment

Juvenile rheumatoid arthritis is an autoimmune-prone disease that causes inflammation and joint stiffness in children up to 16 years of age

Depending on the number of joints involved in this inflammatory process, juvenile rheumatoid arthritis is distinguished into pauciarticular, polyarticular, and systemic.

Types of juvenile rheumatoid arthritis

Pauciarticular arthritis stands for at most four affected joints; it is the most common type of Juvenile Rheumatoid Arthritis and usually affects large joints such as the knees.

This type of disease can cause eye disease and presence of ANA antibodies in the blood.

Frequent visits to the ophthalmologist will help avoid serious eye problems, such as inflammation of the iris or uvea.

Polyarticular arthritis, on the other hand, indicates that more than 4 joints have been affected, most commonly hands and feet, but others may also be involved.

Polyarticular arthritis is often symmetrical, that is, it affects even joints (hands, feet, knees, etc.).

In the blood of people with this type of disease, it is easy to find IgM rheumatoid factor antibodies.

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Systemic arthritis is characterized not only by swelling and inflammation of the joints, but also by fever and skin rash

This type of disease also involves internal organs, such as the spleen, liver, heart, and lymph nodes.

Only a small percentage of these children, however, develop arthritis in many joints and may be prone to severe arthritis during adulthood.

The major difference between rheumatoid arthritis in adults and juvenile rheumatoid arthritis lies in the fact that while children with the latter often outgrow the disease, adults, on the other hand, have lifelong symptoms.

In fact, according to some studies, the symptoms of juvenile rheumatoid arthritis disappear in more than half of affected young people however, unlike rheumatoid arthritis in adults, they can affect normal bone development and growth in young patients.

Symptoms of juvenile rheumatoid arthritis

Typical symptoms of juvenile rheumatoid arthritis are persistent joint swelling, pain, limitation in movement, and stiffness, especially in the morning.

The joints most affected are the knees, hands and feet.

Inflammation in the eyes can be considered another typical sign of juvenile rheumatoid arthritis and can complicate if not followed and treated properly.

As a consequence, the physical appearance of young patients may also be altered: because this disease essentially greatly limits bone growth and development, patients may be smaller than normal or may have, for example, one leg longer than the other.

Diagnosis of juvenile rheumatoid arthritis

First of all, the doctor will consider symptoms that have been present for more than six weeks: swelling, skin rash, fever, inflammation of internal organs, in order to pose the diagnosis.

Laboratory tests per se are not a test to pose a diagnosis, but only to classify the type of rheumatoid arthritis that has affected the child.

The most common tests are for ANA antibodies, rheumatoid factor, and erythrocyte sedimentation factor.

Radiography is only necessary if the physician suspects bone or cartilage damage or abnormal bone development.

Treatment and therapy of juvenile rheumatoid arthritis

The aim of therapy is to preserve the patient’s physical and social function at as high a level as possible, so anti-inflammatory drugs and analgesics will be prescribed.

NSAIDs are the most commonly used drugs, although many physicians avoid prescribing them because of the side effects these drugs cause.

Other drugs often administered are corticosteroids, used especially in children with a very severe degree of the disease.

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Source:

Pagine Mediche

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