Infantile arthritis, also known as juvenile rheumatoid arthritis, is a rare disease that occurs in children up to the age of 16 and causes inflammation of one or more joints, causing symptoms such as pain, swelling and redness in the joints, and may also affect other organs such as skin, heart, lung, eyes and kidneys.
Juvenile arthritis is rare, and although its causes are not yet fully understood, it is known to be associated with changes in the immune system, genetics and certain infections by viruses or bacteria. However, idiopathic arthritis is neither contagious nor transmitted from parents to children.
It can be divided into different types according to the number of joints affected and the signs and symptoms it causes in other parts of the body:
- Oligoarticular arthritis, in which 4 or fewer joints are affected;
- Polyarticular arthritis, in which 5 or more joints are affected as early as 6 months of disease;
- Systemic arthritis, also called Still's disease, occurs when arthritis is accompanied by fever and other signs and symptoms of involvement of various organs of the body such as skin, liver, spleen, lungs, or heart;
- Arthritis related to Entesitis, which is inflammation at the attachment points of the tendons in the bones, and may or may not compromise the sacroiliac joints or spine;
- Juvenile Psoriatic Arthritis, characterized by the presence of arthritis with signs of psoriasis;
- Undifferentiated, not fulfilling criteria for any category above.
What are the signs and symptoms
The main symptoms of childhood arthritis include:
- Pain and swelling in one or more joints;
- Body stains;
- Irritated eyes and visual impairment when there is ocular inflammation, called uveitis;
- Constant fever below 38 ° C, especially at night;
- Difficulty in moving an arm or leg;
- Increased liver or spleen size;
- Excessive tiredness and lack of appetite.
Some children may not complain of joint pain and so some signs that may indicate arthritis are limping, being very still or having difficulty using your hands to make delicate movements such as writing or painting, for example.
The diagnosis of childhood arthritis is not always easy to do because there is no blood test to help identify the disease, as in the case of adults. Thus, the doctor can do several tests to eliminate some hypotheses until arriving at the diagnosis of infantile arthritis.
Possible causes
The main cause of childhood arthritis is a change in the child's immune system that causes the body to attack the joint membrane, causing injury and inflammation causes destruction of the joint membrane.
However, the problem is not hereditary and, therefore, it is only parents to children, being common the existence of only one case in the family.
How is the treatment done?
Treatment for infantile arthritis should be guided by a pediatric rheumatologist, but usually initiated with the use of anti-inflammatory drugs such as ibuprofen or naproxen, for example, with doses adapted to the child's weight.
However, when these medicines do not work, your doctor may prescribe special medicines that delay the development of the disease, such as methotrexate, hydroxychloroquine, or sulfasalazine, which help relieve symptoms and prevent new joints, immunosuppressants such as Cyclosporine or Cyclophosphamide or the new injectable biological therapies such as Infliximab, Etanercept and Adalimumab.
When infantile arthritis affects only one joint, the rheumatologist may also prescribe corticosteroid injections, such as prednisone, to supplement treatment with other medications and relieve symptoms for a few months.
In addition, the child with juvenile idiopathic arthritis should also have psychological counseling and support from the family as it may present emotional and social difficulties. The intellectual development of the child with arthritis is normal, so she should normally attend school, which should know the situation of the child to facilitate their adaptation and social integration.
Physiotherapy for infantile arthritis
It is also very important to perform physiotherapy for rehabilitation, with exercises that help return the mobility to the joint, so that the child can easily perform activities such as walking, writing and eating. It is also important to exercise flexibility and strength of muscles.
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