Juvenile rheumatoid arthritis: causes, symptoms and treatment

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 can 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 that it is 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 affected joints 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 in the first 6 months of the disease; Systemic arthritis, also called Still's disease, happens when arthritis is accompanied by fever and other signs and symptoms of the involvement of several organs of the body, such as skin, liver, spleen, lungs or heart; Arthritis related to Entesitis, which is inflammation in the attachment points of the tendons in the bones, with or without the involvement of 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; Stains on the body; Irritated eyes and altered visual capacity when there is eye inflammation, called uveitis; Constant fever below 38ºC, especially at night; Difficulty moving an arm or leg; liver or spleen size; excessive tiredness and poor appetite.

Some children may not complain of joint pain and, therefore, some signs that may indicate arthritis are limping, being very quiet or having difficulty using their hands to make delicate movements, such as writing or painting, for example.

The diagnosis of childhood arthritis is not always easy to make, 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 reaching the diagnosis of childhood 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 membrane of the joint, causing injury and inflammation causing the destruction of the membrane of the joint.

However, the problem is not hereditary and, therefore, it is only from parents to children, being common the existence of only one case in the family.

How the treatment is done

Treatment for childhood arthritis should be guided by a pediatric rheumatologist, but it is usually started 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 drugs have no effect, the doctor may also prescribe special remedies that delay the development of the disease, acting on immunity, such as methotrexate, hydroxychloroquine or sulfasalazine, which help to relieve symptoms and prevent the appearance of new lesions in joints, immunosuppressants, such as Cyclosporine or Cyclophosphamide or new injectable biological therapies, such as Infliximab, Etanercept and Adalimumab.

When childhood arthritis affects only one joint, the rheumatologist may also prescribe injections of corticosteroids, such as prednisone, to complement the treatment with other drugs and relieve symptoms for a few months.

In addition, children with juvenile idiopathic arthritis must also have psychological support and support from the family, as they may have emotional and social difficulties. The intellectual development of the child with arthritis is normal, so he should normally attend school, which should know the child's situation to facilitate his adaptation and social integration.

Physiotherapy for child arthritis

It is also very important to perform physical therapy for rehabilitation, with exercises that help to restore mobility to the joint, so that the child can perform activities such as walking, writing and eating without difficulty. It is also important to exercise flexibility and muscle strength.