Surprising facts about juvenile arthritis.

When we picture our children, their seemingly endless amounts of energy might jump into our minds. Whether running around for an hour at a soccer game and recharging with oranges brought by the parent of the week or climbing trees like a monkey all afternoon, they seldom stop.

Children's Health | Muscle and Joint


Owen Wiseman
@AVogel_ca


20 February 2018

This is why it may seem surprising to discuss arthritis and children in the same sentence as arthritis is commonly regarded as an aging disease.

Juvenile arthritis

Juvenile arthritis is an umbrella term for a variety of inflammatory rheumatic autoimmune conditions that develop in children under the age of 16. The immune system is responsible for defending our bodies against foreign invaders and pathogens like viruses or bacteria. The cells on our team get trained to attack only the foreign cells rather than our own, much like those video games where you get points for shooting the aliens and lose points for targeting a civilian. When these cells start acting up and attacking our own cells, this results in an autoimmune disease.

For those children suffering from arthritis, this battle often occurs in the synovial fluid that lubricates joints such as the elbow or knee. The role of this fluid is to minimize friction between the bones so they maintain their strength and structure throughout our life. The joints swell as the macrophages, the cells that gobble up invaders, start to munch on our own cells where they normally shouldn’t. However, while the joints are the most common location of the disease, it can occur in other areas.

Types of juvenile arthritis

This disease is commonly referred to as juvenile idiopathic arthritis (JIA) which means the cause is unknown. Currently, estimates place 24,000 Canadian children as suffering from JIA, or 3 of every 1000 kids, so figuring out a way to manage the disease helps many young ones. As mentioned earlier, there are a few types of juvenile arthritis:

  • Oligoarthritis: Affects fewer than five joints with symptoms including swollen joints such as the wrist, elbow, or ankle in addition to potential swelling of parts of the eye, most often the iris. This disease also impacts females more often than males, and often in the child’s second or third year.
  • Polyarthritis: Causes swelling in five or more joints, often the small joints of the fingers and hands, within the first six months of the disease. Like oligoarthritis, this type of JIA also affects females more than males. In addition to the swelling, the disease is further differentiated by whether the child is rheumatoid factor (RF) negative or positive. RF are proteins produced by the immune system that can attack healthy tissue in the body, so high levels circulating in the blood are a marker of an autoimmune condition.
  • Psoriatic arthritis: In addition to swelling of the joints, these children also develop a scaly, red rash and pitted fingernails.
  • Enthesitis-related arthritis: Affects entheses, areas where tendon meet bone, as well as the spine and hips. This form is predominant in male patients and there is often a family history of male relatives with arthritis in the back.
  • Systemic arthritis: This form of arthritis affects many systems of the body such as the heart, lymph nodes, and/or spleen, but unlike other forms, the eyes are usually unaffected. Due to the whole body effects, many children also experience a rash of the limbs in addition to high fever.

How to manage the symptoms

As seen, each form of JIA presents with varying symptoms, so first and foremost is getting an accurate diagnosis via your primary care provider. Afterwards, treatment can begin with the following tips to help manage the disease:

  • Something fishy. Omega-3 fatty acids have shown promising results on species known as cytokines. These play a large role in the inflammatory response of the immune system and the swelling related to JIA. Omega-3 fatty acid supplements reduce the activity of these cytokines and by extension, the inflammation experienced. Omega-3 fatty acid supplementation has allowed some patients to reduce their medication through their doctor as shown in some studies, thus decreasing the risk of drug related side effects. Regular consumption of fish such as mackerel, lake trout, herring, and salmon can supply a beneficial amount of the nutrient.
  • Symptomatic relief. Arnica has been shown to improve joint functionality and alleviate symptoms in those suffering from osteoarthritis. This is thought to be achieved through its ability to reduce the levels of pro-inflammatory cytokines circulating in the blood and increase antioxidant levels. These results can be achieved through topical products such as Absolüt Arnica Gel applied to the area of inflammation.
  • Get those legs moving. Exercise such as aquatic, aerobic, or Pilates has been shown to provide phenomenal benefits in children suffering from JIA with their activity capacity and quality of life increasing with the activities. Not only are these great ways for your child to manage their symptoms and stay healthy, it can get parents engaged in activity and provides some fun family bonding.

References:
http://www.arthritis.org/about-arthritis/types/juvenile-arthritis/
https://www.ncbi.nlm.nih.gov/pubmed/21922187
https://www.ncbi.nlm.nih.gov/pubmed/23728701
https://www.ncbi.nlm.nih.gov/pubmed/28049960
https://www.ncbi.nlm.nih.gov/pubmed/28176230
https://www.ncbi.nlm.nih.gov/pubmed/28690841
https://www.ncbi.nlm.nih.gov/pubmed/28729171
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295114/
https://www.niams.nih.gov/health_info/Juv_Arthritis/juvenile_arthritis_ff.asp#2
http://www.webmd.com/rheumatoid-arthritis/diagnosing-juvenile-arthritis#1

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