In this article we will take a closer look at how rheumatism manifests itself in a child. Symptoms, varieties, treatment features, diagnosis and prevention are the main issues that we will focus on.
Let's immediately draw your attention to the fact that rheumatism can develop absolutely at any age. This is a disease of an infectious-allergic nature. The variety of clinical manifestations is due to the fact that rheumatism does not affect a specific organ, but connective tissues that are present in all human organs. Consider the signs of rheumatism in children.
What is this?
Let's start our article with the very concept of "rheumatism". What is this disease? This is the name of an inflammatory disease that affects the entire body at the same time (that is, it is systemic). The origin of rheumatism is infectious-allergic. It has another name: Sokolovsky-Buyo disease.
The disease is characterized by damage to the connective tissue. The connective tissues of the cardiovascular and central nervous systems are mainly affected. There is a statisticalinformation that indicates that women most often suffer from this disease - three times more than men. However, this difference disappears in adulthood.
What are the characteristics of rheumatism in children? Symptoms and treatment of the disease in childhood are slightly different. This is due to the fact that children's rheumatism has some features, such as:
- more pronounced severity of damage to the cardiovascular system;
- changes in other systems and organs;
- the possibility of the transition of the disease into a chronic form (the percentage of probability in childhood is very high);
- recurrence.
The chronic form manifests itself as follows: after treatment, there is a period of rest, but after a while the problem reappears. It is worth noting that relapses of rheumatism are observed in children very often.
The symptoms of rheumatism in children aged 2 or 10 are practically the same. Please note that children from seven to fifteen years of age are especially susceptible to the disease. Children's rheumatism threatens with a number of complications, including heart failure. Rheumatism often begins to develop after infectious diseases. These include scarlet fever, tonsillitis, and so on.
Especially often the focus is found in the cardiovascular system. Rheumatism is common throughout the world, especially in disadvantaged countries where rates of the disease are very high.
We will take a closer look at the symptoms and diagnosis of the disease in childhood later, but now I want to pay attentionon the Jones criteria. It is important to note that he distinguishes between large and small criteria. If at least one sign from the first category is observed, then this is enough to diagnose the disease.
| Big Criteria | Small Criteria |
| Carditis (occurs in 70% of cases), polyarthritis (75%), erythema (up to 10%), chorea (up to 10%), subcutaneous nodules (up to 20%). | Fever, arthralgia, history of rheumatism, increased ESR or CRP. |
Symptoms
Now we will take a closer look at the symptoms of rheumatism in a child. As mentioned earlier, rheumatism can destroy connective tissue in several organs at once. This can explain the large number of various manifestations of the disease. It all depends on the form and severity of the processes.
The causative agent of rheumatism stimulates the production of a substance called C-reactive protein. It is he who causes inflammation and damage to the connective tissue. Again, we draw your attention to the fact that rheumatism does not appear from scratch. The process of its development begins after an infectious disease. In total, there are three forms of the disease, we will talk about them a little later. The main feature of rheumatism is an acute onset. Symptoms include:
- a sharp increase in body temperature;
- strong weakness;
- feeling worse.
Common initial symptoms have now been listed. In small children (2years) symptoms of rheumatism can be:
- irritability;
- tearfulness;
- sleep disorders and so on.
Further, other symptoms that characterize one of the forms of rheumatism will gradually join them. Rheumatism in children, the symptoms and treatment of which we consider in the article, can manifest itself in different ways, but in about 85% of cases, the disease threatens with heart complications.
Classification
In total, there are three forms of the disease:
- articular;
- heart;
- nervous.
We'll talk about them in detail a bit later.
It is worth noting that the symptoms of streptococcal rheumatism in children do not go unnoticed. The disease always entails consequences in the form of complications, or rheumatism becomes chronic.
The symptoms of rheumatism in children 10 years of age and younger are completely different. An experienced specialist can easily diagnose the disease at any stage.
Rheumatism has two phases:
- active;
- inactive.
What are the criteria for disease activity? These include:
- severity of manifestations;
- changing laboratory markers.
Based on this, there are three degrees of rheumatism. They are presented in the table below.
| First degree | Minimum activity | Clinical and laboratory signs are very mild at this stage. |
| Second degree | Moderate activity | The second degree of streptococcal rheumatism in children, the symptoms of which are already clearly expressed, is easily diagnosed. This is because clinical, radiological and other signs are already visible. |
| Third degree | Max activity | Characteristic features are: fever, signs of rheumatic heart disease, articular syndrome, sudden changes in laboratory parameters and so on. |
Articular form
Now consider the symptoms of rheumatism in a child of the articular form. Let's start the chapter with a little bit of statistical information. Babies rarely fall into this category. In almost 20% of cases, articular rheumatism manifests itself between the ages of one and five years; and almost 80% - from ten to fifteen years.
Symptoms of rheumatism of the joints in children can manifest as follows:
- fever;
- weakness;
- headaches;
- joint pain;
- redness and swelling over the joints and so on.
Despite the fact that cases of diseases are numerous, the pathogen has not yet been identified. Undoubtedly, rheumatism has an infectious character. This infection affects in most cases the lymph nodes located in the nasopharynx. Diseases are associated with previous tonsillitis, caries, and inflammatory processes.
It is worth noting that there are several theoriesoccurrence of the disease. Rheumatism of the joints in children, the symptoms and treatment of which we consider in this article, according to the majority, is of an infectious-allergic nature. This is the most widely accepted theory. If you adhere to this opinion, then rheumatism is the consequences of an allergic reaction in the human body. Due to the entry into the cells of the waste products of bacteria in the incubation period, the body is reconfigured. Streptococci in this case are capable of causing the above symptoms of rheumatism.
It has already been said that the cause of rheumatism is often a previously transferred infectious disease (in particular, scarlet fever). However, other examples can be given:
- hypothermia;
- overvoltage.
Many symptoms indicate that the CNS (central nervous system) is involved in this process. These symptoms include:
- chorea;
- motor disorders;
- mental illness;
- nervous diseases and so on.
It is important to note that all of the above diseases are very often accompanied by rheumatism. Studies show that the reactivity of the cerebral cortex is significantly reduced. This can be easily determined by an experienced specialist. Why is this happening? This is usually associated with an increase in the excitability of the subcortical centers, which affects the entire body.
Heart shape
Now we offer a little more talk about the cardiac form of rheumatism in a child, the symptoms of thisailment. We immediately draw your attention to the fact that heart problems can begin both simultaneously with the articular form of rheumatism, and appear gradually. A severe form of rheumatism is characterized by the fact that the symptoms of cardiac dysfunction appear very slowly, that is, the disease develops imperceptibly.
We said earlier that the hallmark of articular rheumatism is a sudden and violent attack. There are sharp pains, and so on. However, some children may complain of mild joint pain and fatigue. Even then, heart problems can develop. To avoid serious consequences and start treatment in a timely manner, go for a consultation with a specialist even with such complaints.
Rheumatism of the heart in children, the symptoms and treatment of which we will consider right now, is commonly called rheumatic heart disease. The initial stage practically does not manifest itself in any way. Symptoms include:
- fatigue;
- no games;
- reluctance to run;
- dyspnea;
- palpitations;
- pale skin.
The severe form is accompanied by an elevated temperature, usually not exceeding thirty-eight degrees. The general condition of the child is deteriorating daily.
The cardiac form of rheumatism can lead to some of the heart problems shown in the table below.
| endocarditis | violation of the inner lining of the heart |
| myocarditis | medium |
| pericarditis | outdoor |
| pancarditis | all three |
All this leads to the development of heart disease, that is, the inflammatory process passes to the valves. It is very important to know that timely treatment and compliance with the prescribed regimen is the key to a happy future. Many children who suffer from heart defects lead a normal life (go to school, go out with friends, attend circles, and so on). If the case is neglected, then the disease takes a severe form, which affects the state of he alth as follows:
- presence of a circulatory disorder;
- swelling of limbs;
- strong breathlessness;
- enlarged liver.
Another distinctive feature of the severe form of the disease is a ring-shaped rash on the skin. Seek immediate medical attention at the first symptoms! Timely treatment is a chance for a normal life for a child that should not be missed.
Nervous form
In this section of the article we will pay attention to the nervous form of rheumatism in children. Symptoms and treatment of the disease are the main issues that we will try to cover in this article.
A distinctive feature of the nervous form of rheumatism in children is chorea, damage to certain parts of the brain. Chorea develops gradually, symptoms may include:
- mood change;
- irritability;
- tearfulness;
- muscle twitches (notethat this symptom is capable of progressing; some parents think that the child is grimacing and naughty, not even realizing the true state of affairs);
- lack of discipline;
- carelessness;
- handwriting change;
- appearance of slurred speech;
- loose gait.
As for the lack of discipline and negligence, it is also worth making some clarifications. In fact, the child is not to blame. He really cannot lace up his shoes neatly, often dropping forks, spoons, pens and other items. Pay attention to these symptoms. Many confuse this with fatigue or carelessness. In fact, the child needs your help. These symptoms will appear for about three months. Pay more attention to the behavior and condition of the child, so as not to miss the right moment and start treatment on time.
The good news in this disease is that heart damage in the nervous form of rheumatism is extremely rare. If the disease has given any complication to the cardiovascular system, then the disease proceeds very easily. If you notice at least some changes in the behavior of the child, consult a doctor.
Now let's pay a little attention to hyperkinesis. This is a condition that occurs at the very height of the disease. During this period, a person is always in motion (he cannot sit, stand or lie still). There are involuntary muscle contractions that can interfere with the child when eating (contractions of the muscles of the tongue,lips, etc.). They spread to other muscle groups, the following signs may appear:
- constant blinking;
- tongue sticking out;
- grimacing.
Please note that during sleep, all symptoms of hyperkinesis disappear. In addition to all the above symptoms, the examination can detect reduced muscle tone. No special examinations are required in severe forms, when it is visible to the naked eye. A child with a severe form of the disease cannot hold his head or sit. As a rule, all symptoms last from three weeks to three months. Then they gradually subside. Be sure to keep in mind that relapses are quite common (the time of manifestation is about a year after the last case, sometimes much earlier).
With chorea, body temperature may slightly increase (up to 37.5 degrees). There may be swelling and pain in the joints.
Reasons
In this section of the article we will try to analyze in detail the question of the causes of rheumatism in children. As mentioned earlier, even modern medicine cannot give an accurate answer to this question. There are several theories, and starting from them, we can conclude that many factors can serve as causes.
| Factor | Explanation |
| Recent infectious diseases | These include acute respiratory infections, tonsillitis, scarlet fever, tonsillitis and so on. It is important to note that they are caused by group A streptococcus. It is worth clarifying that infection with an infectionis not the main condition for the development of rheumatism. This requires a malfunction of the immune system. Only in this case, it begins to attack he althy cells. This manifests itself in cases where the treatment was started out of time (late) or it is simply wrong. |
| The second factor is hereditary | During a series of studies and surveys, it was found that the hereditary factor also plays a role in the development of rheumatism. It has been noted that the disease often occurs in members of the same family. |
| Long-term carriage of streptococcal infection | As a rule, streptococcus can live in the nasopharynx for a long time, as a result of which the immune system malfunctions. The result - the development of rheumatism. |
| Minor factors | No matter how strange it may sound, there are other (minor) factors that can cause the development of rheumatism in childhood. These include: hypothermia, overwork, poor nutrition. How does this affect the development of the disease? Quite simply, these factors have an adverse effect on the child's immune system. As a result, the likelihood of developing rheumatism increases several times. |
Diagnosis
What is rheumatism in children (symptoms, photos, causes are given in the article), now, we hope, it is clear. We turn to the diagnosis of the disease. To begin with, it must be said that absolutely anyone can suspect a child of having a disease, starting with parents andeducators and ending with a pediatrician or rheumatologist.
The clinic of rheumatism in children (clinical manifestations) is varied. It is important to know the main criteria:
- carditis (any kind);
- chorea (we paid a lot of attention to this disease earlier);
- presence of nodules under the skin of a child;
- erythema;
- polyarthritis;
- recent strep infection;
- hereditary factor.
If a child has at least one of these symptoms, you should immediately consult a doctor. In addition to these criteria, there are others:
- arthralgia;
- fever;
- altered blood counts.
For diagnosis, it is not enough to examine and question the patient. For an accurate diagnosis, it is necessary to conduct a series of laboratory tests, which include a chest x-ray, ECG, echocardiography.
X-ray helps to determine the configuration of the heart, ECG will show cardiac abnormalities (if any), Echocardiography determines the presence of heart disease.
Treatment
We looked at the diagnosis and symptoms of rheumatism in children. Treatment of the disease is the next question. In this case, an integrated approach is needed. Rheumatism treatment aims at:
- symptom relief;
- effect on streptococcal flora.
Rheumatism in children (symptoms, treatment and photos of which we are considering) is treated in a hospital. Please note that therapy is carried out even if this is suspected.disease.
Baby needs:
- bed rest with a gradual increase in activity;
- proper nutrition, diet contains an increased amount of potassium;
- proper organization of leisure activities.
Drug therapy is based on:
- antibacterial drugs;
- hormonal;
- anti-inflammatory;
- vitamin complexes;
- potassium preparations;
- immunostimulants.
All these drugs help fight pathogenic microflora. As a result, the inflammatory process is removed and the symptoms of the disease are noticeably reduced. It is important to note that drug treatment may have some side effects:
- development of an ulcer;
- gastric bleeding;
- disturbances in the work of the endocrine glands.
Prevention
This section is dedicated to the prevention of rheumatism in children. Distinguish between primary and secondary prevention. In the first case, attention is paid to the proper development of the child:
- hardening;
- proper nutrition;
- sport;
- fight against group A streptococcus infections.
Secondary aims to prevent relapse:
- "Bicilin 5" - 1.5 million units once every four weeks for schoolchildren;
- "Bicilin 5" dosage of 0.75 million units once every two weeks for preschoolers.
Please note that it is recommended to prevent exacerbationsyear-round, monthly. The recommended duration is five years.
Forecast
Many mothers were able to cope with this disease by going to the hospital in time for medical help. If you carry out the prevention of rheumatism, then a relapse will not pose a threat to life. We analyzed in detail the issue of rheumatism in children, symptoms, reviews. What are the predictions?
Note that rheumatic heart disease in about 25 percent of cases is accompanied by the development of heart disease. Reappearance does not leave a chance to avoid valve damage. As a result, cardiac surgery is required. The lethal outcome from heart failure is approximately 0.4%. It should be noted that the outcome of the disease depends on the correctness and timeliness of treatment.
