Juvenile Rheumatoid Arthritis: What You Need To Know

Juvenile Rheumatoid Arthritis is an autoimmune disease that affects youngsters and involves joint swellings and pain. It is often precipitated as a consequence of a rather innocuous viral or bacterial infection, and can also involve other parts of body making diagnosis a bit difficult.
Juvenile Rheumatoid Arthritis: What You Need to Know
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Juvenile Rheumatoid Arthritis is a condition that affects children and adolescents, and can create immense anxiety in them as well as their guardians. Since it has many variants that also involve other organs, the symptoms can sometimes by difficult to appreciate and even create doubts about their accuracy. Being aware can be a great advantage in its early recognition.

 

JUVENILE RHEUMATOID ARTHRITIS (JRA) is a condition in which swelling, pain and deformity of joints occur in children in the age group of 6 months to 16 years. Sometimes arthritis is also associated with other conditions like fever, rash, slow growth and

eye problems. It is also known by the names of JUVENILE IDEOPATHIC ARTHRITIS and JUVENILE CHRONIC POLYARTHRITIS.

An Overview of JRA

This condition is an 'auto-immune' disease wherein the immune system of the body, which normally attacks infections, starts attacking the structures of the joints, leading to their swelling, injury and pain. Why it happens in some individuals only, is still not fully understood, but it is often precipitated by certain bacterial and viral infections. Some protein of the bacterial or viral body is recognized as a 'foreign body' by the immune system but unfortunately the antibodies or the killer cells produced by the immune system to destroy those 'foreign bodies' can not differentiate some of the body structures, like joints, from those 'foreign bodies' and thus end up damaging the joints instead.

Varieties of JRA

The condition may involve many joints and depending upon the number of joints involved it can be of three varieties.

- POLYARTICULAR refers to involvement of more than 5 joints.
- PAUCIARTICULAR means involvement of less than 5 joints.
- In SYSTEMIC variety, multiple joints are involved along with other structures of body, leading to fever and pink rash.

The severity of Juvenile Rheumatic Arthritis can vary from a temporary flare of a couple of joints, which disappear after some time, to a persistent arthritis affecting many joints.

Need for Increasing Awareness about JRA

Juvenile Rheumatoid Arthritis is one of the most common cause of arthritis in children and affects

around 50,000 children in United States alone. Since younger children have difficulties in expressing their problems, so for all parents and school teachers, it is very important to be aware of this condition. Sometimes the affected child may not be able to tell anything but he will be less active, will avoid outdoor running and games or show limping or difficulty in using hand. In all such happenings, the possibility of arthritis must be kept in mind.

Many a times swelling of joints may not be apparent from the outside, and conforming the diagnosis requires X-ray, CAT scan or MRI. Joint deformities suggest a long lasting disease, which may result from a delay in diagnosis due to inability of the parents and teachers to timely notice the problem.

Treatment of JRA

Most common medicines used are NSAID pain relievers like DICLOFENAC (SULINDAC), IBUPROFEN (KETOROLAC). In some children injections of steroids into the joints help in reducing swelling and preventing permanent damage. Other useful medicines include immuno-modulator medicines like METHOTREXATE which help by reducing the severity of immune response, but should be avoided in those with infections. Recently newer medicines have also become available. ENBREL (ENTERCEPT)belongs to a newer category of 'TNF blockers' which are being used for this condition. In 2006, U.S. Food and Drug Administration (FDA) have approved CELEBREX (CELECOXIB), a selective COX-2 inhibitor type of NSAID for treating Juvenile Rheumatoid Arthritis in children aged two years or more.

Other therapies that can help in some children include physiotherapy and massage therapies. Alternative medicines and therapies can also be tried. One must remember that regulated exercise as per the advice of the physician and avoiding strenuous exercise keeps muscle tone healthy while avoiding injury to joints.
 



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