JIA, juvenile rheumatism: growth retardation and painful joints

It is often assumed that rheumatism is a disease of old age, but it can also occur in children. It is assumed that one per mille (1:1000) of all children suffer from JIA. This corresponds to approximately 2,500 children annually. The abbreviation stands for Juvenile Idiopathic Arthritis and is also called juvenile rheumatism. What does this condition mean, what are the consequences for the child and how is it treated?

JIA, juvenile rheumatism

  • Related to autoimmune disease
  • Different types of JIA
  • What are additional symptoms?
  • Treatment of juvenile rheumatism

Related to autoimmune disease

Although the cause has not yet been determined, it appears to be caused by the immune system. In other words, the immune system ensures that cells containing certain proteins in the joints are attacked. This can cause joint inflammation and pain at a young age. The synovium is affected by the autoimmune disease, causing it to swell. It causes several joints to hurt, which can cause the child to experience a lot of discomfort. In addition, it can also negatively affect other tissues during growth. What types of juvenile arthritis are there and what can be done about them?

Different types of JIA

The condition occurs in varying degrees in children. This concerns the following variants.

Oligo-articular rheumatism

No more than four joints are affected at the same time. It is the most common, often involving the knee, ankle, wrist or elbow joint (articulus cubiti). It is easily treatable, after which it recurs several times or heals immediately. It has no further consequences for the joints. Sometimes the condition lasts a very long time and in exceptional cases the spine also becomes chronically inflamed (Bechterew’s disease). The early variant often affects young girls, where the eyes also become inflamed. The late variant concerns pubescent boys, where tendons and nerves can also become inflamed.

Polyarticular rheumatism

At least five joints are affected at the same time. In addition to the large joints, it also affects the small joints. In other words, the hands and feet become inflamed, which can occur from an early age until puberty. This variant lasts for a long time and will gradually calm down. One child has a lot of damage to the joints and the other has little to none.

Systematic rheumatism (Still’s disease)

In addition to joints, other tissue is also inflamed, and organs can also be inflamed. It has an erratic pattern of occurrence, where it is suddenly active again and then weakens again for a period. If the child has an attack, general malaise will apply. High fever, a lot of pain and red spots everywhere. The liver, spleen and lymph nodes may be inflamed, which causes little inconvenience. If the pericardium or lining of the lungs becomes inflamed, it can cause many problems. Think of difficult or wheezing breathing, shortness of breath, fatigue or palpitations. This variant of the disease is very difficult to treat, because different places in the body are affected.

What are additional symptoms?

Because rheumatism is present, it always involves painful complaints. Pain can occur in different degrees. It may present as a rapid onset of pain, after which it gradually subsides. It can also cause severe pain for a long time. It can also lead to:

  • the child tries to prevent pain by crawling or sliding on the buttocks instead of walking;
  • growth is significantly limited. Certain medications also cause growth retardation. Sometimes it is treated with growth hormone to catch up. Slow growth is often experienced as very confrontational;
  • Osteoporosis can occur through the administration of medication, but also due to the disease itself. The risk of a fracture therefore increases rapidly because bone formation is not or hardly stimulated. Poor bone growth also affects further growth.

Because the medication is intense, it can cause additional complications. Always read the package leaflet and follow the advice of the treating doctor.

Treatment of juvenile rheumatism

Depending on the degree of juvenile rheumatism, the treatment is also diverse. The child often receives similar medication as older rheumatism patients. If it concerns oligo-articular pain, it may involve simple painkillers in combination with an anti-inflammatory agent. Think of NSAIDs or corticosteroids. A more serious degree may involve heavier rheumatoid medication, such as methotrexate (MTX) or Enbrel (etanercept as a biological anti-inflammatory). Be well informed about the consequences of certain medications for the child’s development. Make sure that you consume enough dairy products containing vitamin D3 and K2 to further stimulate bone production. Combine it with growth hormones if necessary. Inquire about the possibilities to allow the child to grow sufficiently.

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