Juvenile Rheumatoid Arthritis

The juvenile rheumatoid arthritis is considered to be an auto immune disease of the conjunctive tissue that is characterized by a chronic inflammation in articulations and some extra-articular manifestations like fever, rashes, large liver and spleen. As opposed to the typical rheumatoid arthritis, the one encountered in children is usually a self-limited disease with a good outcome, not causing functional handicaps in adulthood.

Te cause of this disease is unknown. It debuts usually before 16, restraining four or more articulations and being characterized by pain at their level, inflammation and limited movements. Amongst the factors that predispose children to develop this condition we can enumerate:

- The exaggerate immune reaction on self tissues, witch believes to be foreign to the body
- Bacterial or viral infections that are considered to trigger the auto immune process
- Genetic factors that lead to abnormal reactions of the immune system

Today, the possibility that families who have kids with juvenile rheumatoid arthritis have genes that make them susceptible at auto immune diseases is taken into consideration.

The positive diagnose is based on three exams: the clinic exam, the Para-clinic exam and the symptoms’ history.

The symptoms that guide to a positive diagnose might include : a history of bruises and pain at one or more articulations, that appear suddenly without any explanation, a prolonged fever that has no determined cause, knowing that juvenile rheumatoid arthritis is one of the causes of prolonged fever in children.

Although it can appear at any age, the juvenile rheumatoid arthritis usually appears between 2 and 6. The disease has an unpredictable evolution especially during its first years, with periods of remission and outburst, the passing from one period to the other being sudden and without a visible reason. The long term prognostic of a child is influenced by the type of rheumatoid arthritis he had. Whilst a child with juvenile rheumatoid arthritis with 4 or less affected articulations has a good long term prognostic, besides the sight problems risk, one with arthritis in more than 5 articulations or with systemic juvenile rheumatoid arthritis (witch means he presents a general symptomology) usually has more problems in the long run.

For a child that has juvenile rheumatoid arthritis in more than five articulations, the following factors can mean that he presents an increased risk of developing articulation deforming and dysfunctions during adult ages:

- The disease is still active after the age of 10
- Rapidly progressive articulation lesions
- Chronic symptoms that do not respond to treatment
- General symptoms like fever, tiredness and lack of appetite
- Nodules under skin, in all the pressure areas (like elbows and heels)