Causes Are Not Exactly Known
The exact cause of childhood rheumatism is often unknown. Although it is said that environmental factors are effective along with genetic predisposition, neither the exact genetic mechanism nor which environmental factors are truly effective in a significant part of the diseases has been proven.
Child rheumatism diseases generally occur as a result of an abnormal response of the immune system. It occurs as a result of autoantibodies (antibodies formed against the body's own cell building blocks) creating an inflammatory reaction in the body. As a result of this abnormal and exaggerated immune response, inflammation occurs in the skin, joints, kidneys, brain, heart and lung membrane, and if this condition is not treated appropriately, it causes damage to the organs.
Symptoms and Findings Occur Gradually
One of the most important features of childhood rheumatism diseases is that disease-specific symptoms and findings often do not appear at the same time. On the contrary, diagnostic signs and symptoms appear over time. Therefore, it is difficult to make an early diagnosis and there are often delays in diagnosis. For example, to make a diagnosis of the disease called Juvenile Idiopathic Arthritis, the signs and symptoms of the disease must continue for at least 6 weeks; To determine which subgroup the disease falls into, it must be monitored for 6 months.
Systemic lupus erythematosus (SLE) begins with symptoms such as mild fever, weakness, fatigue, and loss of appetite, which can be confused with many other diseases. In SLE, sometimes the only initial symptom is a decrease in the number of platelets that initiate blood clotting. This condition is confused with the blood disease called idiopathic thrombocytopenic purpura (ITP).
It Affects Many Organs and Systems
Pediatric rheumatism diseases do not affect a single system, but mostly many. affect the organ together. Therefore, it causes symptoms in the form of dysfunction of various organ systems. Even though it mainly affects the musculoskeletal system; When kidney, brain, blood cells, heart and lung involvement occurs, it causes clinical and laboratory signs and symptoms of these organs. For example, skin rash, hair loss, chest pain, abdominal pain, headache, high fever, seizures, blood Cellular disorders (anemia, low or high platelet and leukocyte counts) may be a sign of rheumatic disease.
Confused with Non-Rheumatic Diseases
Similar complaints and findings; It can also be seen in cases of infectious diseases (bone and joint infection), some cancers (osteosarcoma, leukemia, etc.) and orthopedic problems (torn meniscus, osteoarthrosis, etc.). Therefore, it is necessary to distinguish rheumatic disease from non-rheumatic disease with appropriate diagnostic methods.
Main Diseases
Main pediatric rheumatic diseases Juvenile Idiopathic Arthritis (JIA), Ankylosing Spondylitis, Inflammatory Bowel Disease Arthritis, Familial Mediterranean Fever, SLE, Juvenile Dermatomyositis, Scleroderma, Vasculitides (Henoch-Schönlein Purpura, Kawasaki Disease, Polyarteritis Nodosa, Etc.), Behçet's Disease, Sjögren's Syndrome, Reactive Arthritis, Pain Syndromes and other rare These are diseases.
Diagnosis is made by detailed history and examination, laboratory is helpful
In pediatric rheumatology, disease diagnosis is often made (80-85%) by detailed disease history and examination. It is diagnosed based on physical examination findings. The contribution of imaging methods and laboratory tests to the diagnosis is around 10-15%.
The main symptoms of these diseases are; fever, joint complaints (pain in the joint, swelling, increased temperature, limitation of movement), morning stiffness in the joint, muscle weakness, walking problems, skin rash, Raynaud's sign (when the hands or feet are exposed to cold, they first turn white, then turn blue and turn pink again when they warm up). ' is.
There is no response to treatment in a short time, the response to treatment is slow. Medicines Have Side Effects
One of the most important features of childhood rheumatism diseases is the lack of dramatic response to treatment in a short time. Healing occurs slowly; most of the time, medications need to be used continuously for at least 3-4 months for them to take full effect. This causes disappointment in families and may lead to treatment noncompliance due to impatience. In addition, rheumatism medications often cause disturbing side effects in the patient (nausea, vomiting, stomach pain, liver dysfunction, bleeding, etc.). This makes it difficult to continue the treatment. n is a factor. For all these reasons, the family must be in full harmony and cooperation with the physician and treatment team. Otherwise, the desired result cannot be obtained from the treatment.
Tight Coordination with the Family and Child Caregivers is Required
Since the treatment period can last months to years and sometimes covers the entire childhood period. , the family and those carrying out the treatment must work in harmony with patience.
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