Juvenile idiopathic arthritis (JIA) is a common rheumatic disease occurring in children under 16 years of age, and its incidence is about 121-220 per 100000 people. Once the child is found to have symptoms such as tenderness, swelling and limited mobility, the parents should take the child to the children's rheumatism department of the regular hospital for diagnosis and treatment as soon as possible. If there are joint symptoms and eye symptoms, it should be ruled out in time whether you have iridocyclitis. If confirmed, you need to cooperate with the doctor to receive long-term standardized treatment to avoid deterioration of the condition and blindness. At the same time, such children are particularly sensitive to the climate. Now Shencheng has entered the plum rain season. The main characteristics of such weather are continuous cloudy rain, high temperature and humid atmosphere, and low pressure. In such a "humid" environment, it is easy to make the children's condition repeated or aggravated. Parents need to pay more attention.
At present, according to the characteristics of the course of juvenile idiopathic arthritis, children with systemic juvenile idiopathic arthritis are divided into monophasic, polyphasic and persistent stages. The prognosis of monophasic type children is good, and a small amount of non steroidal anti-inflammatory drugs can control the disease, with good prognosis and no obvious sequelae, but the proportion is low. Most children with persistent and polyphasic arthritis need hormone therapy to control their condition. If the dosage is reduced too quickly or insufficient, the disease is prone to relapse, and the delay is difficult to control. It is the most difficult type of juvenile idiopathic arthritis to control the disease. The results of many clinical studies abroad suggest that the incidence of decreased bone mineral density in adults with a history of juvenile idiopathic arthritis is about 40-52%.
The study also found that in addition to the impact on bone, the growth of children is slower than that of healthy children, because abnormal immune molecules are produced in the body and affect the function of the growth hormone axis through the cytokine network, resulting in height growth disorders. Other types of arthritis are more likely to have disability consequences than systemic arthritis. When some severe children have high fever, significantly faster erythrocyte sedimentation rate, obvious joint involvement symptoms, eye damage caused by disease and even blindness risk, and it is difficult for non steroidal anti-inflammatory drugs to control the disease, but the disease is in a long-term active state and osteoporosis occurs, the clinical needs to use hormone therapy as appropriate to quickly control the disease. However, hormone is a "double-edged sword". On the one hand, it is an effective anti-inflammatory drug, which can inhibit inflammation in a relatively short time and control the progress of the disease. On the other hand, it also increases the risk of bone lesions, which will have a greater negative impact on children in growth and development. In the treatment of juvenile idiopathic arthritis, in addition to hormones, other non steroidal anti-inflammatory drugs, methotrexate, hydroxychloroquine, leflunomide, sulfasalazine, and other anti rheumatic drugs to alleviate the disease, as well as immunosuppressants such as cyclosporine A, azathioprine, and cyclophosphamide can control the disease, and the drugs themselves are less likely to cause osteoporosis, but they also affect the blood system Reproductive system, cardiovascular system and other side effects, so there are also many worries.
In recent years, with the deepening understanding of juvenile idiopathic arthritis, more and more treatment methods can alleviate the condition of children to a certain extent. Especially with the use of emerging biological agents in recent years, the proposed target site treatment strategy has played a very important role in relieving the symptoms of children. Although there are also drug risks such as susceptibility to infection, the negative effects of drugs such as hormones on children in growth and development are significantly reduced, and these emerging treatment methods will certainly bring good news to children. Clinical treatment found that after receiving long-term standardized individualized treatment, most children's joint function and disease activity indicators have been significantly improved, and can continue to maintain its efficacy, and will not affect the bone development of children as hormone treatment, greatly reducing the disability rate of children's joints. (JM Zhang Xingyuan)
Experts interviewed:
Cao Lanfang, Chief Physician of Pediatrics, Renji Hospital Affiliated to Jiaotong University School of Medicine
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