Michele (Was: Re: RE: Heartbreaking (a little off topic)

[Guest guest]

Michele, I too, thought of your son and mine. I hope that if/when the disease

rears its ugly head, that they will take action and get treatment. I think that

thought was another part of why I was so upset yesterday. Seeing this man not

given any hope and thinking there but for the grace of God goes my son..

Rheumatic Diseases in Children: Disease Patterns

> >

> > Disease Patterns

> > http://home.t-online.de/home/rheuma-kinderklinik/rke-e002.htm

> >

> > Many people think of " rheumatism " still as being a disease of

> > adults or

> > seniors. That is not the case: For one thing, rheumatism is not

> > a single

> > disease but a collective term for many different illnesses. In

> > the other

> > hand unfortunately also children and adolescents contract the

> disease.> Besides there are a few rheumatic diseases which occur

> almost> only in

> > children. The rheumatic diseases have in common that the

> immune system

> > does not work properly and begins to attack not only foreign matters

> > (e.g. viruses or bacteria) but also body's own tissue. Joint

> > inflammations can thus arise. Also impairments in tendons, muscles,

> > blood vessels and other organs can develop.

> >

> > Below we shall give a short survey about the most important

> rheumatic> diseases of childhood and adolescence.

> > 1. Transient synovitis of the hip (itis fugax)

> >

> > The most frequent joint inflammation in children is called transient

> > synovitis of the hip. This inflammation of the hip joint involves

> > chiefly children between the 3rd and 10th year of life. They

> suddenly> start to limp, refuse to walk, and complain of pains.

> Transient> synovitis of the hip is generally painful, but

> resolves completely

> > without any lasting sequelae in most cases. But often at onset

> > it is

> > difficult to isolate it from other partly severe diseases of

> the hip.

> > Therefore various examinations may be required before a certain

> > diagnosis can be set.

> >

> > 2. Reactive Arthritis

> >

> > Many joint inflammations develop as a reaction of the body's own

> > defensemechanisms to previous infections with bacteria or

> > viruses. Quite

> > frequently they may be observed after gastrointestinal

> > infections with

> > diarrhea. They are named postinfectious or reactive arthritis or

> > sometimes acute rheumatism. Often swellings and warming of one

> > or more

> > joints are seen. These illnesses can have a lengthy course and

> > be quite

> > painful. Young children often report no pain at all. At a close

> > look one

> > can sometimes observe in the beginning a change in movement or

> > gait. In

> > most cases postinfectious arthritis heals completely and

> leaves no

> > permanent injuries in the joints.

> >

> > 3. Lyme-Arthritis

> >

> > The Lyme-arthritis or borrelia induced arthritis is a special

> > form of

> > joint inflammation. Lyme is the name of the place in

> > Connecticut, USA,

> > where this type of arthritis has been first described.

> Borrelia are

> > bacteria transmitted by tick-bites and can cause various

> > diseases, among

> > others also this joint inflammation. Here we often see pointed

> > swellingsof single joints, quite often of the knee or ankles. In

> > the blood and in

> > the joint fluid of the children and adolescents concerned various

> > antibodies against borrelia can be found. This identification is

> > important because borrelia-arthritis can effectively be

> treated with

> > antibiotics. There are, however, also cases in which the

> > arthritis takes

> > a protracted course despite of sufficient antibiotic

> treatment. Then

> > there is the danger of lasting damage to the joints involved.

> >

> > 4. Juvenile chronic arthritis

> >

> > The term juvenile chronic arthritis (JCA) refers to a group of joint

> > inflammations which are also called chronic rheumatism. Little

> > is yet

> > known about its origin. But it seems certain that several

> > factors are

> > involved in the development of these diseases. Hereditary

> > predispositions as well as previous infections, accidents

> (traumata),> and excessive stress may be of importance for the

> manifestation> of JCA.

> > But often the disease starts without any known previous illnesses.

> >

> > JCA lasts longer than the other forms of arthritis mentioned

> > above. A

> > special danger of JCA consists of the fact that the inflammatory

> > processcan impair the joints permanently if one does not succeed

> > in halting it

> > as early as possible. This can result in lesions of the articular

> > cartilage and malpositions of the joints.

> >

> > JCA is usually classified into various subgroups:

> >

> > 4.1 Systemic Juvenile Chronic Arthritis

> >

> > The systemic juvenile chronic arthritis (SJCA) concerns about

> > 10% of the

> > children with chronic arthritis. Often the onset is already in

> infant> age. High fever is apparent in the beginning, recurring

> over several

> > weeks, especially in the morning and afternoon, and does not

> > respond to

> > antibiotics. A rash is partly seen, especially during the febrile

> > phases. Enlargement of liver and spleen is possible. Every 3rd

> > to 4th

> > child incurs a pericarditis. An inflammation of the pleura and

> > peritoneum can join the condition.

> >

> > At onset of disease fever as well as muscle and joint pain are

> > often in

> > the fore without joint swellings. Later on these conditions mostly

> > retreat and an arthritis develops. In some children the arthritis

> > remains limited to few joints, often, however, are many large

> > and small

> > joints involved.

> >

> > 4.2 Early Onset Oligoarthritis (Type I)

> >

> > This form of JCA is also called " young girls' type " because it

> > concernsabout 70-80% girls and only about 20-30% boys. Disease

> > onset is usually

> > between the first and sixth year of life. As a rule only a few

> > (up to 8

> > maximally) joints are affected. Knee joints and ankles are mostly

> > involved, but inflammation may also be found at elbow, hand and

> > finger,or toe joints. The distribution is mainly asymmetric,

> > i.e. the joints

> > are not equally strong involved on both sides of the body.

> >

> > An essential danger of the oligoarthritis type I is the chronic

> > uveitis.This is a matter of an eye inflammation causing no

> > discomfort in the

> > beginning, however producing grave eye injuries if undetected.

> > Thereforeespecially patients with oligoarthritis type I must

> see the

> > ophthalmologist regularly!

> >

> > 4.3 Juvenile Polyarthritis

> >

> > Polyarthritis means that there is an inflammation (arthritis)

> of many

> > (poly) joints. At least there are five joints affected, in most

> > patients, however, eight to ten or even more. While the

> pattern in

> > oligoarthritis is asymmetric, it is mostly symmetric in

> polyarthritis:> The joints of the body's right and left side are

> equally afflicted.

> > There may be an arthritis in large joints like shoulders, hips,

> > or knees

> > as well as small ones like finger- or toe-joints. Often there

> is not

> > only an inflammation of the joints but of the tendon sheaths too.

> >

> > Onset of disease can be at any age and concerns girls slightly more

> > often than boys. It means a considerable handicap for the

> > children as

> > due to the disease they are greatly hampered in their natural

> > urge for

> > motion.

> >

> > The juvenile polyarthritis is also named seronegative

> > polyarthritis as

> > the rheumatoid factor is not present in the serum.

> >

> > 4.4 Chronic Polyarthritis of the Adult Type

> >

> > In contrast to the juvenile polyarthritis can the rheumatoid

> > factor in

> > the adult type be identified. Therefore it is called seropositive

> > polyarthritis. It affects mostly girls from the 11th year of

> > life on and

> > presents similar to the seronegative polyarthritis. However, the

> > finger-end joints are often spared. Beside the arthritis

> inflammations> of the blood vessels (vasculitis) can also develop.

> >

> > Since the seropositive polyarthritis can progress rather fast and

> > produce damage on the joints if untreated, it is important to

> > recognizeit early and treat it correctly.

> >

> > 4.5 Oligoarthritis Type II ( " Big Boys' Type " )

> >

> > As the name " big boys' type " says mostly boys from school age

> on are

> > confronted with this form of arthritis. As in the oligoarthritis

> > type I

> > mainly large joints are affected, the distribution pattern is

> > asymmetric.

> > Mostly involved are knee- and ankle-joints, but also the hip

> > joints or

> > joints of the upper extremity. Typical for the disease pattern

> > is an

> > inflammation of the tendon appendages, so e.g. in the area of

> > the heel,

> > beneath the patella or on the crista iliaca.

> >

> > Also in the oligoarthritis type II eye inflammations can

> occur. This

> > acute uveitis presents itself, however, with pain, reddening and

> > shunning of light, so that it cannot be overlooked. With proper

> > treatment it heals quickly and resolves without any consequences.

> >

> > If in addition an inflammation of the sacroiliacal joints

> > develops one

> > does not speak of oligoarthritis type II but of juvenile

> > spondarthritis. From this at later age a Morbus

> > Bechterew may turn up. If this happens

> > it might be after about the 20th year of life.

> >

> > 4.6 Psoriasis Arthritis

> >

> > Psoriasis is a chronic skin disease. About one third of the patients

> > develop joint problems, many of them arthritis. While in adults

> > usuallythe skin symptoms appear first and the arthritis follows,

> > we see in

> > children often the arthritis before distinct skin lesions lead

> > to the

> > diagnosis psoriasis.

> >

> > The psoriasis arthritis mostly proceeds like oligoarthritis

> and rather

> > benign, but can also spread to many joints. Typical is the

> involvement> of single fingers and toes.

> >

> > 4.7 Others

> >

> > Chronic arthritis is also observed in inflammatory bowel

> disease like

> > Morbus Crohn and colitis ulcerosa. Inflammatory diseases of the

> > connective tissue may also be accompanied by arthritis.

> >

> > 5. Rheumatic Fever

> >

> > Before antibiotic treatment was established, rheumatic fever was

> > a quite

> > common disease. Nowadays it is hardly ever seen. Rheumatic fever

> > followsan infection with certain bacteria (streptococcus). It causes

> > inflammations in the joints and of the heart. In order to prevent

> > lasting heart injuries effectively an antibiotic treatment is

> > indispensable.

> > Lately a rising number of patients with rheumatic fever was reported

> > from the USA. This statement, however, is not secured. In

> > Western Europe

> > such observations have not been made.

> >

> >

> >

> >

> >

> >

> > To leave this mailing list, send request to:

> > -unsubscribe <mailto: -

> unsubscribe%40>>

> >