Reactive arthritis in children is a pathological process that develops as a result of an infection in the body. Such a disease can be detected after suffering enterovirus, influenza, pneumonia, hepatitis B, etc. According to doctors, chlamydia of the genitourinary system most often leads to reactive arthritis in children, and intestinal diseases are in second place.
Recently, this problem has been detected quite often. But what contributes to the development of the disease? As a rule, this is an infection and microbes that were not completely eliminated from the body in the treatment of a previous disease. Next, we will consider in detail why arthritis develops, and we will figure out how to avoid the development of this serious ailment.
Causes of pathology
To date, the exact cause of reactive arthritis in children has not been established. Doctors believe that this ailment develops due to a genetic predisposition and pathological reactions of the immune system. It was noted that the disease is more often diagnosed in adolescents aged 11-14 who have a history of enterocolitis (intestinal infections), infection of the nasopharynx and urogenital system, as well as vaccination.
Recently reactive diseases include only urogenital and enterocolitic arthritis. The reason for their development are various viruses and bacteria, such as:
- yersinia;
- Shigella Flexner;
- Salmonella
- clostridia;
- chlamydia
- immunodeficiency virus and much more.
Reactive arthritis is usually a single disease, its development does not lead to epidemics. Doctors are not always able to determine the route of infection. This is due to the presence in nature of a large number of different microorganisms, as well as the high susceptibility of the child's body. Also, a significant role is played by the transmission of chlamydia: airborne droplets, contact household, sexual and intrauterine.
How is the disease manifested?
Postenterocolitic reactive arthritis in children develops a couple of weeks after enterocolitis. In some cases, this period can stretch to a month. In this case, the middle joints of the feet and toes are affected, usually this occurs symmetrically.
In addition, the inflammatory process can spread to the eyes, tendons, aorta, and heart. Extraarticular diseases are characterized by inflammation of the myocardium, membranes and anatomical structures of the organs of vision. These include such pathologies:
- iritis;
- pericarditis;
- myocarditis;
- conjunctivitis;
- keratitis;
- erythema nodosum (inflammation of the skin and subcutaneous vessels).
Genitourinary Diseases Prior to Reactive Arthritis
- Pyelonephritis (inflammation of the renal pelvis).
- Urethritis (inflammation of the urinary tract).
- Jade (damage to the renal glomeruli).
- Balanoposthitis (inflammation in boys of the foreskin).
- Genital infections.
Other diseases that trigger reactive arthritis
- Myocarditis with impaired conduction of the heart.
- Uveitis (damage to the vessels of the organs of vision).
- Keratoderma (keratinization of the soles and palms with the formation of papular rashes and painful plaques) /
- Entesin (inflammation of the ligaments and tendons in the place where they are attached to the joint).
How does the baby feel?
Symptoms of reactive arthritis in children are basically the same, despite the microorganisms causing the disease. As a rule, the child has severe joint pain, limb stiffness occurs. When pressing on the affected area, pain is felt. Most often, discomfort is felt during movement. The intensity of the manifestation of symptoms also depends on the circadian rhythm. For example, at night, when the child tries to move, the pain may intensify, while it has a aching, dull and twisting character.
Another sign of reactive arthritis in children is the swelling of the affected area. It occurs when the formation of edema of the diseased joint or intraarticular effusion. In this case, the child has an increase in temperature in the inflamed area. Touching such a place with your hand, you can feel that it is hot. When the small joints of the foot are affected, the fingers swell and become cyanotic. It is worth paying attention that in the absence of inflammation, the disease cannot be considered reactive arthritis.
Diagnosis of the disease
At the reception, the doctor examines the child, and also checks whether he had previously encountered infectious lesions of the gastrointestinal tract or genitourinary system. The girls must be examined by a gynecologist. In addition, it is necessary to conduct detailed instrumental and laboratory studies. These include the following diagnostic methods:
- general tests of urine and blood;
- immunological analysis for the detection of antibodies to microorganisms of the intestinal group and chlamydia;
- cytological examination to determine the cell structure;
- bacteriological analysis determines sensitivity to antibiotics.
Treatment
We examined the causes and symptoms of reactive arthritis in children, now it's time to talk about treatment. The disease in the acute stage requires a hospital stay. Such treatment consists of several directions:
- elimination of pain;
- elimination of residual effects of the underlying disease that preceded arthritis;
- direct treatment of the affected joint.
To relieve pain, the doctor prescribes non-steroidal drugs in various forms. It can be tablets, ointments and gels. The latter include such effective drugs as Ortofen, Voltaren, Ketanol and Diclofenac. If the pain is very severe, then glucocorticosteroid medicines are prescribed.
Treatment of reactive arthritis in children with antibiotics may not give good results. However, such drugs are simply necessary in the acute stage of the disease. Teens are often prescribed tetracycline drugs such as Oletetrin, Tetracycline, Metacyclin, and more. For younger children, less toxic medications are suitable. As a rule, these are macrolides of semisynthetic and natural origin:
- Josamycin.
- "Oleandomycin."
- "Midecamycin."
- Spiramycin.
- Leukomycin.
- Erythromycin.
Macrolides have a bacteriostatic effect. They help well with coccal microflora and chlamydia. Chronic forms of the disease are treated by prescribing a range of drugs. As a rule, this includes antibiotics and immune stimulants (Polyoxidonium, Likopid, Aquitin).
Unfortunately, the treatment of arthritis in children does not always end in a full recovery. Often, the disease progresses and drags on, which leads to the development of its chronic form. Remember that self-medication and drug experiments can cause your child to be hospitalized for a long time.
Prevention of reactive arthritis in children
Reactive arthritis in children, the symptoms and treatment of which we examined above, is a rather serious disease, so it is better to prevent its development in advance. What can we do to protect our children from this ailment? the best way is timely prevention. Consider what is included in such events:
- parents should lead a healthy lifestyle and set an example for their child;
- Be sure to follow the rules of hygiene;
- it is necessary to carry out timely sanitation of infectious foci;
- parents should immediately treat chlamydia;
- when planning pregnancy, it is recommended to conduct a study of the genotype.
Disease prognosis
If your child has been given a disappointing diagnosis, do not be upset ahead of time, because the prognosis of reactive arthritis is most often encouraging. Modern methods of treatment can completely eliminate the disease and prevent further relapses. However, if the pathogen enters the body again, clinical manifestations may resume. If the child has a hereditary predisposition to pathology, reactive arthritis can become chronic and exacerbate from time to time, bringing discomfort and pain.
The result of reactive arthritis in children can be spondylitis, when the inflammatory process goes to the joints of the spine. And this is already a very serious disease, which significantly worsens the quality of life of the patient. But how can we prevent such dangerous complications? At any time of the year, it is necessary to take care of strengthening the children's immune system. For this, doctors recommend hardening, often walking in the fresh air, correctly alternating physical activity with rest. The child should have a balanced diet, his body should receive all the necessary minerals and vitamins. Living conditions also play a large role. The house should be clean and fresh. An important point is a spa vacation, which allows you to maintain the body at the proper level.