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Rheumatism in children is a disease of an allergic and infectious nature, systemically affecting the synovial membranes of the joints, the connective tissue of the heart and blood vessels, the serous membranes of the skin, the central nervous system, the eyes of the lungs, the liver and kidneys.
In medical terminology, you can find another name for childhood rheumatism – Sokolsky-Buiko disease.
The average age at which this disease is diagnosed varies from 7 to 15 years. Rheumatism has no population limitation and is widespread throughout the world.
Symptoms of rheumatism in children
The first signs of the disease can be noticed at least a week after the transferred streptococcal infection and a maximum of a month.
Symptoms of the manifestation of rheumatism are as follows:
Rheumatic heart disease. It is characterized by an inflammatory process in several or all layers of the heart wall, may be accompanied by pericarditis (damage to the outer lining of the heart), myocarditis (inflammation of the heart muscle), endocarditis (inflammation of the connective lining of the heart) and pancarditis (includes inflammation of all layers of the heart). Among the complaints made by young patients caused by rheumatic heart disease, fatigue, shortness of breath, the occurrence of pain in the heart, and the development of tachycardia can be noted.
Polyarthritis. It is accompanied by damage mainly to large and medium joints, the appearance of pain in them. The disease develops symmetrically.
Chorea. It affects more often girls and appears in the form of increased irritability, tearfulness, frequent mood swings. Then gait begins to suffer, handwriting changes, speech becomes slurred. In the most severe cases, the child will not be able to eat and care for himself on his own.
Ring erythema. Accompanied by rashes that look like pale, slightly pinkish rings. Mostly located on the stomach and chest. The affected areas do not itch or peel.
Rheumatic nodules. They are formed in the form of subcutaneous formations, localized mainly on the back of the head and in the place where the joints join the tendons.
These are the five leading symptoms accompanying childhood rheumatism. In parallel, the patient may suffer from fever, abdominal pain, nosebleeds. Dangerous are repeated attacks of rheumatism that occur a year later. At the same time, the symptoms of intoxication increase, heart defects develop, including: mitral valve prolapse, aortic insufficiency, stenosis of the aortic mouth, etc.
Causes of rheumatism in children
Among the causes leading to the development of rheumatism in childhood, include:
Firstly, acute respiratory infections, scarlet fever, pharyngitis, tonsillitis or tonsillitis, caused by group A hemolytic streptococcus. However, one infection is not enough for rheumatism to begin to develop. It is necessary that the infection provoked a malfunction of the immune system, which, in turn, begins to “attack” healthy cells in the body. Often this is due to inadequate or untimely treatment of streptococcal infections.
Secondly, the hereditary factor. Studies show that rheumatism can be traced in members of the same family.
Thirdly, long-term carriage of streptococcal infection in the nasopharynx can provoke inadequate functioning of the immune system and cause rheumatism in childhood.
In addition, there are secondary factorsinfluencing the development of the disease. These include overwork, hypothermia and poor nutrition, which, in turn, reduces immunity and increases the risk of contracting infectious diseases.
Diagnosis of rheumatism in children
Both a pediatrician and a pediatric rheumatologist can suspect the presence of a disease in a child.
The reason for further research is the specific criteria that guide each doctor:
Any type of carditis;
The presence of chorea;
Formation of subcutaneous nodes;
Erythema;
Symptom polyarthritis;
Postponed streptococcal infection;
Hereditary predisposition to rheumatism;
Positive response to specific therapy.
In addition, there are small evaluation criteria that make it possible to suspect a disease, these are: arthralgia, fever, specific blood parameters (accelerated ESR, decreased hemoglobin, neurophilic leukocytosis, etc.).
Therefore, in addition to studying the anamnesis, standard examination and questioning of the patient, it is necessary to carry out laboratory tests:
It also makes sense to have a chest x-ray. This study allows you to determine the configuration of the heart (mitral or aortic), as well as cardiomegaly.
Conducting an ECG will allow you to see violations in the work of the heart, and phonocardiography to determine the presence of damage to the valvular apparatus.
In order to indicate the presence of a heart disease in a child, an echocardiogram is shown to him.
Complications of rheumatism in children
The disease is dangerous for its complications. Among them is the formation of heart disease. At the same time, its valves and partitions are affected, which leads to a violation of the functionality of the organ. Often the progression of the defect occurs with repeated attacks of the disease on the child’s body. Therefore, it is so important to take the patient to a consultation with a cardiac surgeon in time and, if necessary, perform an operation in a specialized clinic.
Other possible complications include inflammation of the inner lining of the heart, thromboembolism, cardiac arrhythmias, and the formation of congestive heart failure. These conditions are deadly, they can provoke the development of a heart attack of such vital organs as: the spleen and kidneys. Often there is cerebral ischemia, circulatory failure.
To avoid complications of the disease, it is important to notice the signs of rheumatism in a timely manner and begin treatment.
Treatment of rheumatism in children
Children with a diagnosis of rheumatism are placed for treatment in a hospital. During the acute period of the illness, it is important that the patient stay in bed. Its duration is determined by the condition of the child and the nature of the disease. If rheumatism is mild, then bed rest should be followed for about a month. After this period, the child is prescribed physiotherapy exercises. Unlike an adult, it is difficult for children to maintain minimal activity. Therefore, parents need to properly organize his leisure time. Board games, coloring books, books, etc. will come to the rescue.
Drug treatment is reduced to the elimination of the pathogen that led to the development of the disease. Most often, antibiotic therapy based on penicillin is used for this.
In addition, the child needs auxiliary therapy, which consists in prescribing vitamin complexes, taking potassium preparations. Children usually spend up to 2 months in the hospital. Doctors who observe small patients are cardiologists and rheumatologists.
It is important to sanitize all existing foci of inflammation; without this, rheumatism therapy will not be successful. We are talking about caries, sinusitis, tonsillitis.
When the patient is in remission, he is shown sanatorium treatment. For prevention, a course of NSAIDs is used in the fall and spring. Reception time – 1 month.
With timely treatment to the doctor, the risk of death is minimized. Depending on the degree of damage to the heart, the severity of the prognosis for the disease will depend. If rheumatic heart disease progresses and recurs, then this poses the greatest threat to the health of the child.
During the activation of the disease, it is important for a small patient to adhere to a certain diet, which is based on several principles:
Avoid foods rich in simple carbohydrates. This is due to the fact that such products often provoke allergic reactions during an exacerbation of the disease, which may not have previously been observed.
The menu should be as varied as possible with fruits and vegetables.
In the acute phase of the disease, it is necessary to eat one egg a day, excluding Sundays.
If there are serious disturbances in the work of the heart, then for several days (for 3 days), it is necessary to refrain from protein foods, eating only vegetables and fruits. You can drink up to 300 ml of milk per day.
It is important to saturate the body with vitamin C. Therefore, it is necessary to consume greens and citrus fruits.
It should be understood that the treatment of rheumatism should be comprehensive and based not only on taking medications, but also on well-organized nutrition, and on the correct daily routine.
Prevention of rheumatism in children
Since the disease is dangerous with serious complications, its timely prevention is important. Regarding rheumatism, it is customary to distinguish both primary preventive measures and secondary ones. The former are aimed at preventing the disease and preventing infection of the child, and the latter at preventing cases of recurrence of the disease, as well as the progression of rheumatism.
In order to avoid the disease, preventive measures should be taken from childhood:
Firstly, it is necessary to competently organize the life of the child, this includes physical education, long pastime in the fresh air, hardening, proper nutrition with a low carbohydrate content.
Secondly, it is the strengthening of the child’s psyche. These measures will help maintain the defenses at the proper level and, in case of infection, help the body cope with the infection faster.
Thirdly, the primary preventive measures include isolation of a patient with streptococcal infection and monitoring of contact children. This will make it possible to identify the infected in time and start treatment faster, as well as prevent the spread of the disease in the teams.
Fourth, if an infection has occurred, it is necessary to start treatment as soon as possible. It has been proven that if the therapy of streptococcal infection is started no later than on the third day of infection, the risk of developing rheumatism is reduced to zero.
It is important for parents to realize that primary prevention is a necessary measure for which not only medical professionals are responsible. To preserve the health of the child, it is necessary to be attentive to any symptoms of malaise and seek qualified help in time.
As for secondary prevention, it is due to the tendency of rheumatism to recur. Therefore, children with a similar diagnosis are under medical supervision for a long time. They are observed by a rheumatologist, cardiologist, orthopedist and other narrow specialists.
It is important to maintain the patient’s immunity at the proper level, which will ensure a high resistance of the body to rheumatism. In addition, doctors should have special control over children whose families have cases of the disease among close relatives, including brothers and sisters.