What is juvenile rheumatoid arthritis and which therapies are effective

Let’s consider what juvenile rheumatoid arthritis is, the conventional medical therapies and the most effective remedies to combat this serious condition.

Rheumatoid arthritis is an autoimmune disease that affects the joints and can lead to severe disability.

Juvenile idiopathic arthritis is a rheumatoid disease common in children, begins before the age of 16 and lasts at least 6 weeks (Hahn – 2010).

This condition usually affects the same joint on both sides of the body.

A child may not have any symptoms for a long time (remission). However, children with severe rheumatoid arthritis have a low chance of remission.


Causes of juvenile rheumatoid arthritis

Rheumatoid arthritis has no specific cause, but is thought to be caused by a combination of genetic, hormonal, and environmental factors that trigger an abnormal immune response.

Risk factors:

  • family members with rheumatoid arthritis,
  • Female.

Symptoms of juvenile rheumatoid arthritis

Children with juvenile arthritis do not necessarily have symptoms.

To begin with, the symptoms of rheumatoid arthritis are:

  • Reddened and overheated joints,
  • Joint swelling, pain and stiffness, especially in the morning.

As the disease progresses, the following occur:

  1. limping (younger children may lose the motor skills they learned before),
  2. Persistent fever,
  3. Rash
  4. Weight loss
  5. Irritability
  6. Reddened eyes,
  7. Eyestrain
  8. blurred vision,
  9. Fatigue
  10. loss of appetite.

Consequences of juvenile rheumatoid arthritis

The consequences are:

  1. Slowdown in growth,
  2. irregular growth of an arm or leg,
  3. vision loss or reduction in vision due to chronic uveitis,
  4. Anaemia
  5. Pericarditis (inflammation of the sac around the heart).

Diagnosis of juvenile rheumatoid arthritis

A positive history of swollen joints is required to diagnose rheumatoid arthritis.

The doctor needs to know how many and which joints are affected.

To diagnose rheumatoid arthritis, other conditions that show symptoms of lupus or gout must be ruled out.

To facilitate the diagnosis, the doctor will order some examinations:

  • Blood:
    • Antinuclear antibodies (ANA) – to detect autoantibodies; most tests are positive for children’s rheumatoid arthritis; about 80% of children with eye involvement are ANA-positive.
    • Rheumatoid factor (RF) – can be positive or negative depending on the type of juvenile arthritis a child has;
    • Blood cell sedimentation reaction (BSR) or C-reactive protein (PCR) – to detect inflammation in the body
    • Complete blood count – to evaluate the child’s red and white blood cells and hematocrit. This is helpful for assessing complications such as anemia.
  • Instrumental investigations such as:
    • X-rayof joints and chest – to identify the presence of joint inflammation or accumulation of fluids in the membranes of the heart or lungs. They are used to rule out other health conditions such as: fracture, tumors, infections or birth defects.
    • Eye exam – to detect eye infections
    • FGC – to detect inflammation in the heart

Therapy for juvenile rheumatoid arthritis

There is no definitive treatment for rheumatoid arthritis.

The goals of treatment are:

  1. pain relief,
  2. reduction of inflammation,
  3. slowing down joint damage,
  4. improvement of functionality,
  5. enabling normal growth of the child,
  6. Prevention of joint degeneration over time.

There are several medications to treat pain and inflammation in rheumatoid arthritis.

In general, with juvenile idiopathic arthritis (which includes rheumatoid arthritis), the doctor prescribes drugs to regulate the immune system.

The first line of treatment includes: anti-inflammatory drugs such as methotrexate along with corticosteroids.

Biological drugs should be added in patients who do not respond to therapy.

The following medications are safe and effective in children:

  1. Anti-tumor necrosis factor (infliximab, adalimumab),
  2. monoclonal antibody anti-interleukin 1 (canakinumab),
  3. Biological anti -receptor Interleukin 6 (tocilizumab),
  4. A drug that blocks co-stimulation of T lymphocytes (abatacept).

Immobilization reduces pain and inflammation in the joints, and fatigue is also reduced.

Physical exercise is important for maintaining flexibility, muscle strength and joint mobility.

Devices that help with daily activity can reduce stress on joints. Reducing stress can help you live with a chronic and painful condition.

Hip replacement surgery helps with joint damage.

Diet and natural remedies for rheumatoid arthritis

There are several scientific studies for the diet in rheumatoid arthritis.

In addition, there are many online testimonials from people who have recovered from a Blood Type Diet .

Based on this diet, there are suitable and less compatible foods for each blood group.

For example:

  1. People of blood type 0 should be careful to eat fruits and high-sugar foods or carbohydrates.
  2. Blood group A people can get sick from eating red meat,
  3. People with blood group B cannot tolerate oranges and grapefruit.

According to a 2017 study by Khanna, all people with rheumatoid arthritis should avoid grain products containing gluten. In fact, a gluten-free vegan diet is anti-inflammatory and protects the arteries.

A 2018 study by Badsha states that RA can be prevented by eating fish every day. Also, people with rheumatoid arthritis feel better by eliminating milk and gluten from their diet.

A Mediterranean or vegan diet is recommended, and fasting can also be helpful.

What should you do and what should you avoid?

While there are no guidelines for preventing rheumatoid arthritis, there are some steps you can take to reduce stiffness, weakness, and inflammation.

Preventive measures are:

  • maintain balance between rest and movement,
  • strengthen muscles,
  • aerobic exercise (e.g. walking, swimming, dancing, etc.),
  • avoid vigorous exercise
  • Stop tuxedo,
  • control weight
  • Participate in a physical therapy program.