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Rheumatoid arthritis is tough to live with under any circumstances, but for children, it can be especially difficult. Childhood is supposed to be time of carefree abandon, but growing up with juvenile rheumatoid arthritis (JRA) has a crippling effect on the normal exuberance of childhood. Instead of cavorting with pals on a warm summer day, children with juvenile rheumatoid arthritis often find themselves immobilized by joint swelling and pain.
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What Causes Juvenile Rheumatoid Arthritis?
Research has indicated that JRA is an autoimmune disease that typically manifests between the ages of 6 months and 16 years. In juvenile rheumatoid arthritis, the body’s white blood cells lose the ability to decipher the difference between healthy cells and harmful bacteria and viruses. The immune system then releases chemicals to fight off the “threat" that damage the healthy cells. The result is pain and inflammation. The key to helping your child lead a happy, productive life while growing up with juvenile rheumatoid arthritis is by learning as much as possible about the condition.
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Symptoms of JRA
The symptoms of juvenile rheumatoid arthritis range from barely noticeable to prominent and may include limping and/or tender finger, wrist, and knee joints. Your child’s joints may swell inexplicably and remained enlarged. He/she may also experience stiffness in the hips, neck, or other joints. Another sign that your child may be suffering from JRA is unexpected rashes that suddenly appear and disappear in random areas. High fevers that spike in the evenings are typical of systemic juvenile rheumatoid arthritis.
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Diagnosis of Juvenile Rheumatoid Arthritis
Since joint pain may be caused by so many different things, diagnosing JRA can be somewhat difficult. There is no single test that can definitively diagnose juvenile rheumatoid arthritis. Your child’s physician will likely run numerous tests in order to rule out other maladies that cause similar symptoms. Some of these tests may blood tests, x-rays, and joint fluid removal.
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Treatment: What to Expect
Treatment of JRA may include medications, physical therapy to keep joints flexible and maintain muscle tone, and in the most severe cases, surgery to improve joint positioning. Some medications serve to eliminate pain, while others are devised to halt the progression of the disease. Some typical medications used to treat juvenile rheumatoid arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs), tumor necrosis factor (TNF) blockers, and corticosteroids:
- NSAIDS – You are likely most familiar with this class of drugs, which typically include pain relievers such as ibuprofen (Motrin and Advil) and naproxen (Aleve). These medication help to relieve the pain and swelling associated with JRA, but must be used carefully under a doctor’s supervision to prevent side effects like internal bleeding, liver damage, and stomach problems.
- DMARDs – These drugs are usually prescribed for more severe pain and swelling that NSAIDs alone cannot handle. They help to slow the progression of JRA. Some commonly used DMARDs include methotrexate (Rheumatrex) and sulfasalazine (Azulfidine).
- TNF Blockers – These medications are helpful in reducing pain, swollen joints, and morning stiffness. However, there is an increased risk of infections and cancers such as lymphoma. Common TNF blockers include etanercept (Enbrel) and infliximab (Remicade).
- Corticosteroids – The most severe cases of juvenile rheumatoid arthritis require the use of corticosteroids, such as Prednisone. These drugs are used to prevent complications and to control the most severe symptoms of JRA until the DMARDs take effect. The may be administered either orally or by injection. Since corticosteroids can stunt growth and increase infection risk, they should be used sparingly and for as brief a duration as possible.
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Coping with the Illness
It is crucial for children suffering with JRA to have as much support as possible from family and friends. You should treat your child just as you would any other children in the family. Allow him/her to express frustration about coping with juvenile rheumatoid arthritis. Also, encourage your child to take part in physical activities in accordance with doctor’s recommendations.
If your child is of school age, you will need to work with school administrators and staff to address any schedule or routine concerns. Since mobility is a huge concern with JRA, your child may require extra time moving between classes and help carrying textbooks. When it is necessary to miss school, be sure there are arrangements for assignments to be sent home.
Since JRA can be stressful for the entire family, you should also consider participating in a support group. Socializing with other families who understand your struggles helps to lift some of the burden. They are also online communities and resources that may be helpful in dealing with your child’s JRA. These communities make it easier to find camps, support groups, and conferences dealing with JRA.