Rheumatism in children

Rheumatism in children

Rheumatism in children

Rheumatism in children is an infectious and allergic disease that occurs with a systemic lesion of the connective tissue of the cardiovascular system, joint synovial membranes, serous membranes of the central nervous system, liver, kidneys, lungs, eyes, and skin. With rheumatism, children can develop rheumatic polyarthritis, rheumatic carditis, small chorea, rheumatic nodules, annular erythema, pneumonia, nephritis. Diagnosis of rheumatic fever in children is based on clinical criteria, their connection with a transmitted streptococcal infection, confirmed by laboratory tests and markers. In the treatment of rheumatism in children, glucocorticoids, NSAIDs, preparations of quinoline and penicillin series are used.

Rheumatism in children

Rheumatism in children( rheumatic fever, Sokolsky-Buyo disease) is a systemic inflammatory disease characterized by affection of the connective tissue of various organs and etiologically related to streptococcal infection. In pediatrics, rheumatism is diagnosed mainly in children of school age( 7-15 years).The average population frequency is 0.3 cases of rheumatism per 1000 children. Rheumatism in children is characterized by an acute onset, often prolonged, over the years, with a course with alternating periods of exacerbations and remissions. Rheumatism in children is a common cause of the formation of acquired heart defects and disability.

Causes of rheumatism in children

The experience accumulated in rheumatology allows rheumatism in children to be attributed to an infectious and allergic disease, which is based on infection caused by β-hemolytic streptococcus of group A( M-serotype) and altered organism reactivity. Thus, the incidence of a child with rheumatism is always preceded by a streptococcal infection: tonsillitis, tonsillitis, pharyngitis, scarlet fever. The etiological significance of β-hemolytic streptococcus in the development of rheumatism in children is confirmed by the detection in the blood of the majority of patients of anti-streptococcal antibodies - ASL-O, antistreptokinase, antistreptogialuronidase, antidexoxyribonuclease B, with tropism to the connective tissue.

An important role in the development of rheumatism in children is assigned to hereditary and constitutional predispositions. In a number of cases, a family history of rheumatism can be traced, and the fact that only 1-3% of children and adults who have experienced streptococcal infection get sick with rheumatic fever allows one to talk about the existence of so-called "rheumatic diathesis".

The leading factors in the virulence of β-hemolytic streptococcus are its exotoxins( streptolysin-O, erythrogenic toxin, hyaluronidase, proteinase) that cause pyrogenic, cytotoxic and immune reactions that cause damage to the heart muscle with the development of endomyocarditis, contractility and myocardial conduction.

In addition, the proteins of the cell wall of streptococcus( lipoteichoic acid peptidoglycan, polysaccharide) initiate and support the inflammatory process in the myocardium, liver, synovial membranes. The M-protein of the cell wall suppresses phagocytosis, exerts a nephrotoxic effect, stimulates the formation of anticardium antibodies, etc. The basis of skin and subcutaneous tissue damage in rheumatism in children is vasculitis;Rheumatic chorea is caused by the defeat of subcortical nuclei.

Classification of rheumatism in children

In the development of rheumatism in children, the active and inactive phases are isolated. Criteria for the activity of the rheumatic process are the severity of clinical manifestations and changes in laboratory markers, in connection with which three degrees are distinguished:

  • I( minimal activity) - absence of exudative component of inflammation;weak severity of clinical and laboratory signs of rheumatism in children;
  • II( moderate activity) - all signs of rheumatism in children( clinical, electrocardiographic, radiographic, laboratory) are not pronounced;
  • III( maximum activity) - predominance of the exudative component of inflammation, the presence of high fever, signs of rheumatic carditis, articular syndrome, polyserositis. The presence of distinct X-ray, electro- and phonocardiographic signs of carditis. Sharp changes in laboratory parameters - high neutrophilic leukocytosis. Sharply positive CRP, a high level of serum globulins, a significant increase in anti-streptococcal antibody titres, etc.

Inactive phase of rheumatic fever in children is noted during the interictal period and is characterized by normalization of the child's well-being, instrumental and laboratory indicators. Sometimes between attacks of rheumatic fever is preserved subfebrile and malaise, there is a progression of carditis with the formation of valvular heart disease or cardiosclerosis. Inactive phase of rheumatism in children can last from several months to several years.

The course of rheumatism in children may be acute( up to 3 months), subacute( 3 to 6 months), prolonged( more than 6 months), continuously-relapsing( without clear periods of remission of up to 1 year or more), latent( secretly leading to the formation of valvular heart disease).

Symptoms of rheumatism in children

Clinical manifestations of rheumatism in children are diverse and variable. The main clinical syndromes include rheumatic carditis, polyarthritis, small chorea, anuricular erythema and rheumatic nodules. For all forms of rheumatism, children manifest a clinical manifestation 1.5-4 weeks after the previous streptococcal infection.

The defeat of the heart for rheumatism in children( rheumatic carditis) occurs always;in 70-85% of cases - primarily. With rheumatism, children may experience endocarditis, myocarditis, pericarditis, or pancarditis. Rheumatic carditis is accompanied by lethargy, fatigue of the child, subfebrile condition, tachycardia( rarely bradycardia), shortness of breath, pain in the heart.

Repeated attack of rheumatic heart disease usually occurs after 10-12 months and is more severe with symptoms of intoxication, arthritis, uveitis, etc. As a result of repeated attacks of rheumatism, all children are diagnosed with acquired heart defects: mitral insufficiency, mitral stenosis, aortic insufficiency, stenosis of the aortic estuary, mitral valve prolapse, mitral-aortic defect.

In 40-60% of children with rheumatism, polyarthritis develops, both in isolation and in combination with rheumatic carditis. Typical signs of polyarthritis in rheumatism in children are the predominant lesion of medium and large joints( knee, ankle, elbow, shoulder, rarely - wrist);symmetry of arthralgia, migratory nature of pain, rapid and complete reverse development of joint syndrome.

Cerebral form of rheumatism in children( small chorea) accounts for 7-10% of cases. This syndrome, mainly, develops in girls and is manifested by emotional disorders( crying, irritability, mood swings) and gradually increasing motor impairments. First, handwriting and gait change, then there are hyperkinesis, accompanied by a violation of the intelligibility of speech, and sometimes - the inability to eat and self-serve independently. The signs of chorea completely regress after 2-3 months, but tend to recur.

Manifestations of rheumatism in the form of anuricular( annular) erythema and rheumatic nodules are typical for childhood. Ring-shaped erythema is a kind of rash in the form of rings of pale pink color, localized on the skin of the stomach and chest. Itching, pigmentation and peeling of the skin are absent. Rheumatic nodules can be found in the active phase of rheumatism in children in the occipital region and in the region of the joints, in the places of attachment of tendons. They have the appearance of subcutaneous formations 1-2 mm in diameter.

Visceral lesions in rheumatism in children( rheumatic pneumonia, nephritis, peritonitis, etc.) are practically not found at present.

Diagnosis of rheumatic fever in children

Rheumatism in a child may be suspected by a pediatrician or a children's rheumatologist based on the following clinical criteria: the presence of one or more clinical syndromes( carditis, polyarthritis, chorea, subcutaneous nodules or annular erythema), the association of the disease with streptococcal infection,"Rheumatic anamnesis" in the family, improving the child's well-being after specific treatment.

Reliability of the diagnosis of rheumatism in children must be confirmed by laboratory tests. Changes in the hemogram in the acute phase are characterized by neutrophilic leukocytosis, acceleration of ESR, anemia. Biochemical blood analysis demonstrates hyperfibrinogenemia, the emergence of CRP, an increase in the fractions of α2 and γ-globulins and serum mucoproteins. Immunological examination of blood reveals an increase in the levels of ASG, ASL-O, ASA;an increase in the CIC, immunoglobulins A, M, G, anticardial antibodies.

When rheumatic carditis in children, carrying out a chest x-ray reveals cardiomegaly, mitral or aortic configuration of the heart. Electrocardiography with rheumatism in children can detect various arrhythmias and conduction disorders( bradycardia, sinus tachycardia, atrioventricular blockades, atrial fibrillation and flutter).Phonocardiography allows you to record changes in heart sounds and noise, indicating the defeat of the valve apparatus. Echocardiography plays a crucial role in the detection of acquired heart defects in rheumatism in children.

Differential diagnosis of rheumatic carditis is carried out with non-rheumatic carditis in children, congenital heart defects, infective endocarditis. Rheumatic polyarthritis should be distinguished from arthritis of another etiology, hemorrhagic vasculitis, SLE.The presence of cerebral syndrome in a child requires the involvement of a neurologist and the exclusion of neurosis, Tourette's syndrome, brain tumors, etc.

Treatment of rheumatism in children

Therapy of rheumatism in children should be comprehensive, continuous, long-term and gradual.

In acute phase, inpatient treatment with physical activity restriction is indicated: bed rest( with rheumatic carditis) or sparing regimen for other forms of rheumatism in children. To combat streptococcal infection, antibacterial therapy with penicillin drugs is given for 10-14 days. In order to suppress the active inflammatory process, non-steroid( ibuprofen, diclofenac) and steroidal anti-inflammatory drugs( prednisolone) are prescribed. With a prolonged course of rheumatism in children, complex preparations of quinoline series( plakvenil, delagil) are included in complex therapy.

At the second stage, the treatment of rheumatism in children continues in the rheumatological sanatorium, where general restorative therapy, exercise therapy, mud therapy, sanitation of foci of infection. At the third stage, the supervision of the child by specialists( a children's cardiologist, a rheumatologist, a children's dentist, a children's otolaryngologist) is organized in a polyclinic. The most important direction of dispensary observation is the antibiotic prophylaxis of relapses of rheumatism in children.

Prognosis and prevention of rheumatism in children

Primary episode of rheumatic heart disease is accompanied by the formation of heart defects in 20-25% of cases;However, recurrent rheumatic carditis does not leave a chance to avoid damage to the heart valves, which requires subsequent cardiac surgery. Mortality from heart failure, due to heart defects, reaches 0.4-0.1%.The outcome of rheumatism in children is largely determined by the timing of the onset and the adequacy of therapy.

Primary prevention of rheumatism in children involves hardening, nutrition, rational physical culture, sanation of chronic foci of infection( in particular, timely tonsillectomy).Secondary prevention measures are aimed at preventing the progression of rheumatic fever in children who have suffered rheumatic fever and include the administration of penicillin prolonged action.


Rheumatism in children

rheumatism in children

Unfortunately, children, as well as adults, suffer from chronic diseases. One of these ailments is rheumatism, which in childhood runs hard with a lot of exacerbations and leads to dangerous lesions of the heart and other organs.

Rheumatism in children: causes of

The danger of rheumatism is that this disease is not only infectious, but also allergic. It arises as an allergic reaction of the body to streptococcal infection.

The focus of infection can be any organ and tissue of the body - teeth affected by caries or tonsils, liver, etc. Infection occurs both acute and chronic.

What can provoke the appearance of rheumatism? In many cases, rheumatism appears immediately after the child has had an angina. Exacerbation may occur after a month. During this time, streptococcus creates in the body a specific sensitivity of the body to irritants and an allergic reaction is manifested.

Stresses, any nervous and physical exhaustion can be responsible for the manifestation of the disease, which leads to weakening of the immunity and, as a consequence, to the emergence of a favorable background for the infection.

The course of the rheumatic process can be acute, manifested in the form of attacks, and flaccid - without attacks. It depends on the degree of heart damage. The insidiousness of rheumatism is that with every new attack pathological changes from the heart are amplified. The younger the child, the more serious the disease.

Rheumatism in children: symptoms of

In acute course of the disease With sluggish
1. The temperature may rise 38-39 ° C. 1. A child may complain of lethargy and will quickly become tired.
2. There is pain, there is swelling in the joints. 2. Complaints of mild minor joint pain.
3. The child pales. 3. The temperature can be either normal or slightly elevated to 37-37.6 ° C.
4. Appears shortness of breath. 4. Signs of rheumatism in children are almost not apparent, parents do not pay attention to minor complaints of children and for a long time do not know about the disease.
5. There are signs of heart damage. 5. Gradually, changes in the heart begin to disturb the child, but by that time already revealed the heart defect.

Rheumatism in children: treatment of

Rheumatism of the heart in children is treated depending on how the disease proceeds and in what form.

Treatment for acute disease. Tubotitis :

  1. It is carried out in the hospital( about 6 weeks) with the strictest conditions.
  2. You must observe peace. Have a minimal load on the cardiovascular system.
  3. Drug treatment( 6-8 weeks) with medications such as amidopyrine and salicylic acid preparations( sodium salicylate, salipirin, acetylsalicylic acid) is performed.

Treatment for lethargic illness:

  1. The first 2-3 weeks of treatment should be carried out at the hospital.
  2. How long it takes to comply with bed rest depends on the results of laboratory tests.
  3. If the process of rheumatism is not active the child can be treated on an outpatient basis.
  4. After discharge from the hospital, many children are recommended to have a sanatorium treatment.
  5. Home is also necessary to comply with the regime. It is easy to charge and wipe to the waist in the morning. Food should contain a lot of vitamins. rheumatism of the heart in children Must rest in the afternoon.

Prevention of rheumatism in children

The most important is the strengthening of health through hardening, physical exercises. It is necessary to carry out rehabilitation of those organs that are exposed to chronic streptococcal infection.

A course of antibiotics is prescribed for children suffering from rheumatism in order to prevent secondary exacerbation. Medical preventive measures are conducted 2 times a year for children who are registered for illness. And recently the sick are treated for 5 years under the strict supervision of a doctor.


In order to recognize rheumatism in children in time, it is not necessary to be a doctor. It is enough to be good parents and to know the main signs, at the appearance of which it is necessary to consult a specialist.

The causes of the disease have not been studied so far. But most scientists believe that it is caused by streptococci, especially if the body is sensitive to the infection.

In children and adolescents, the disease is diagnosed more often than in adults. Rheumatism in adults is a complication or continuation of the disease, which was formed in childhood or adolescence. Can lead to the development of congenital heart disease, cardiomyopathy.

Rheumatism is a disease that affects the organs and systems of the child's body. But the main targets are the cardiovascular system and joints.

The onset of the disease

More than half of the cases of rheumatic fever occur at the age of 8-15 years, before rheumatism is rarely diagnosed. The disease is characterized by the development of severe complications.

The later the disease is diagnosed, the harder it is.

Signs of children's rheumatism

The main symptom is joint damage, which develops against the background of infectious diseases( influenza, scarlet fever, angina): a child may get rheumatism immediately or after 15-20 days. Parents should be alerted if, following a previous acute respiratory disease, the following symptoms appear on the background of recovery:

  • swelling and tenderness of the joints( elbows, knees, ankles), with a rise in body temperature;
  • subsequent adherence and pain in smaller joints( foot, hand)
  • migrating pain and swelling: first appear in one joint, then pain and swelling subsiding, but arise elsewhere, then next.

Such lesions can occur against the background of a satisfactory general condition of the child.

A complaint for parents should be the complaint of the child, even for pain in one joint or in several, without raising the temperature and swelling. In the future, the pain completely disappears, in order to appear again after a while.

Heart attack

For a while, this form of rheumatic fever may be asymptomatic, or its onset may be of an increasing nature.

It is necessary to pay attention if the child complains:

  • for fast fatigue
  • for a feeling of weakness after physical exertion( running, walking)
  • , when you get up you have shortness of breath, your heart rate becomes fast.
  • In severe cases it is noted:
  • pain and noise in the heart region
  • shortness of breath takes a more malignant character.
  • fingers and toes acquire blueness
  • forced position( the child takes a pose in which it does not hurt to lie, sit).
  • Heart disorders in rheumatism in children are different:
  • myocarditis( the lesion can pass on its own)
  • endocarditis( can lead to heart defects)
  • pericarditis( the most dangerous lesion).
Doctor recommends Heart disease can be observed both simultaneously with changes in joints, and after a certain time. If the child has noticed the above symptoms, you should not search the network or friends for a solution to the problem, but immediately you need to contact a specialist.

CNS lesion

Girls are more often ill. The parts of the brain are affected, which causes the symptoms:

  • changes the behavior of the child: it becomes emotionally labile( mood swings, tearfulness, irritability, often causeless)
  • the child holds objects in his hands worse( even a spoon or pen), starts illegible writing
  • violated speechand coordination of movements( can not lace up shoes, in severe cases can reach paralysis).

Treatment of

The fight against this complex disease must be entrusted to doctors. No self-treatment!

Recovery depends on timely hospitalization, proper medical treatment in an acute period( in hospital) and following recommendations after discharge:


Rheumatism in children: an article from the journal |Mothers of cribs

It was found that rheumatism is a disease predominantly of childhood and adolescence. Infants are ill with rheumatism very rarely. Rheumatism in adults is most often a continuation of the process that began as a child.

Rheumatism is a serious, serious disease, during which the entire body( cardiovascular and nervous system, liver, kidneys, lungs, joints, skin, etc.) is affected. Especially often, the heart is seriously affected by rheumatism. In the connective tissue located between the muscle fibers of the heart muscle, an inflammatory process develops, special nodules are formed-rheumatic granulomas.

Causes of Child Rheumatism

Most scientists consider rheumatism an infectious chronic disease. The causative agent of it alone is the streptococcus microbe, others are microorganisms - viruses. However, medical experience teaches that in the emergence of rheumatism an important role is played not only by the causative agent, but also by the state of the entire organism of the child, and by its reduced resistance to diseases. The degree of resistance, as it follows from the teachings of the great physiologist IP Pavlov, largely depends on the state of the central nervous system.

In the development of the rheumatic process, the previous illnesses of the child are of great importance: frequent tonsillitis, chronic inflammation of the tonsils( chronic tonsillitis), scarlet fever, and also spoiled( carious) teeth.

Chronic tonsillitis and carious teeth - local chronic foci of infection. Of these, toxins of microbes and decay products of tonsil cells enter the bloodstream. They poison the body and create an increased susceptibility to the disease. To this also leads to dampness and sharp cooling, overfatigue, malnutrition, disordered mode, insufficient body hardening.

Symptoms of rheumatism in children

There are three basic forms of rheumatism : : articular, cardiac and nervous. The articular form of rheumatism begins with a sharp attack. The temperature rises to 38-39 °, there is a headache. After 2-3 days the patient begins to suffer severe pains in the joints( knee, ankle, elbow, wrist), less often the small joints of hands, spine are affected. The aching pains intensify even from touching clothes or blankets, which is extremely worrisome for the child.

Swelling and pain are volatile: they subside in some joints and appear in others. Pain and swelling in the joints usually go through 7-10 days. Chronic affection of the joints on the basis of rheumatism in children, unlike adults, is not observed.

Heart attack, cardiac rheumatism

Simultaneously with joint damage or a little later, there are signs of heart damage, sometimes in severe form. Some children this process develops imperceptibly, slowly.

Not always articular rheumatism begins with violent attacks. Sometimes a child complains only of pain in the joints, severe fatigue. However, even with this form of the disease, changes in the heart can develop. To avoid serious complications, it is necessary to show the sick child to the doctor.

Cardiac form of rheumatism( rheumatic carditis) often begins without pronounced symptoms. The child quickly gets tired, reluctantly plays and reluctantly runs, then he has shortness of breath, palpitations, pallor. With severe forms of the disease, the child's condition deteriorates noticeably every day, the temperature rises to 37.5-38.

In rheumatic heart disease, the inner heart cancers( endocarditis), middle( myocarditis), external( pericarditis) or all three membranes at once( pancarditis) can occur.

The inflammatory process goes on to the valves that cover the openings between the atria and ventricles, and leads to the formation of heart disease. Under the regime and the course of treatment, some children with heart disease feel relatively well. They attend school and lead a normal lifestyle. In other children, despite the measures taken, the disease progresses, there is a blood circulation disorder, edema on the feet, shortness of breath, an enlargement of the liver. For some seriously ill children, you can notice a gentle ring-shaped rash on the skin.

Nervous form of rheumatism: symptoms, chorea

With nervous form of rheumatism in children is more often chorea - rheumatic lesion of some parts of the brain. The disease begins gradually. The child's mood changes, he becomes irritable, whiny. Appear first light, and then progressive twitching of the fingers, muscles of the face-it gives the impression that the child grimaces. He becomes, as it were, undisciplined, careless: he loosens up his shoes badly, he drops his fork and spoon behind his food. The handwriting changes, the speech becomes unclear, the gait is loose. The disease lasts 2-3 months. With a nervous form of rheumatism, heart damage is less common and occurs more easily.

Often, parents and teachers do not know the true state of the child, accepting certain abnormalities in his behavior for prank. One should be attentive to any changes in the behavior of children and, having noticed the symptoms mentioned, it is urgent to see a doctor.

How does rheumatism occur in children?

With all forms of rheumatism, acute, acute and chronic course of the disease is observed. In children, the disease rarely ends with a single attack: usually after the first attack of rheumatism, the process becomes aggravated, a second attack appears, and sometimes several repeated attacks of the disease.

In a calm, so-called interictal period of illness, children seem to be completely healthy;many of them attend school and lead a normal lifestyle. But the guys complain of rapid fatigue, headaches, pain in the legs, sometimes on the heartbeat, etc. A blood test detects symptoms of anemia. With a thorough examination, the doctor finds changes in the heart.

Acute and subacute stage of rheumatism lasts 2-4 months. Sometimes this period is prolonged, so the time of remission of the disease is determined only by the doctor. Frequent exacerbations of the rheumatic process lead to a long, chronic course of the disease. The patient's condition deteriorates significantly, the disease leads to disability, and in severe cases, death. Therefore, children with rheumatism should be under the supervision of a doctor. The doctor performs appropriate treatment at different stages of the disease.

In an acute period, the child needs a strict bed rest period of an average of 1-2 months and is best placed in a hospital. When the condition improves, the patient is gradually transferred to a semi-postal regime, and in the future they are allowed to walk. However, sharp movements( mobile games) are forbidden to him. During this period it is especially important to observe a strict regime.

Treatment and prevention

For fast recovery, prolonged sleep is necessary: ​​nighttime within 10-12 hours and daytime 1.5-2 hours, and children suffering from chorea, up to 14-16 hours per day. Children who suffer from rheumatism sweat violently, so it is good to wipe their body with warm water every morning.

The appetite of a sick child is lowered. To stimulate the appetite, it is necessary to prepare a tasty meal for the patient and to serve so that the appearance of her evokes a desire to eat.

A diet enriched with vitamins is usually used with some restriction of liquid, table salt and carbohydrates. The diet is prescribed as directed by a physician.

As treatment is used and therapeutic exercise. The complex of exercises is set by the doctor individually for each child after a decrease in his temperature. They start with massage, gentle stroking of hands and feet and with breathing exercises. Later, depending on the condition of the child and his cardiovascular system, the complex of exercises gradually increases.

Of medicines for the treatment of patients with rheumatism are used according to the doctor's prescription.

Treatment of local purulent foci( chronic tonsillitis, inflammation of the ears, etc.) is well helped by antibiotics. It is very important timely treatment of carious teeth.

Gamma globulin( a preparation prepared from the blood serum of a healthy person) is used to increase the protective forces of the children's body.

After an acute attack of rheumatism the child is best placed in a sanatorium or at a dacha to promote health and prevent new attacks. Spa treatment is not shown to all children with rheumatism, and not earlier than 10-12 months after the acute phase of the disease, because under the influence of resort factors, the rheumatic process may worsen.

Even in the interictal period, children need special treatment as directed by a doctor.

Children of school age are allowed to study only after the complete abating of the acute period of the disease with the permission of the doctor. If the child's condition requires, the doctor reduces the school load, shortens the school day, and appoints an additional day of rest.

It is generally believed that children who underwent an acute attack of rheumatism are contraindicated in physical education. This opinion can not be considered correct. Depending on the condition of the child, with careful medical supervision, it is possible to resolve physical therapy, skating, and volleyball.

Preventive measures against children's rheumatism

In the fight against rheumatism, in the foreground there are general measures that increase the strength and resistance of the body. Proper physical education, sport, tempering strengthen health and make the body less sensitive to fluctuations in air temperature and drafts.

When a child has catarrh of the upper respiratory tract, quinsy, or if relapses of rheumatic fever occur, it is urgent to see a doctor.

Timely treatment of patients with teeth and chronic tonsillitis is also important for the prevention of angina and the appearance of rheumatism.

Following these tips, parents will be able to protect their children from with children's rheumatism .

Based on the journal "Family and School"


Rheumatism in children - how to treat rheumatism in children |Theravaite. Ru

admin About the disease Rheumatism in children is a systemic inflammatory disease of connective tissue due to the accumulation of uric acid salts in the blood. The disease most often occurs in children aged 7 to 15 years. Very rarely, children under the age of 3 and children over 40-45 years old become ill. It was established that the onset of the disease or its recurrence is preceded by angina, pharyngitis, rhinitis or scarlet fever, streptococci. The cause may be hereditary predisposition, although the disease itself is not inherited. 23-08-2013 Print version

General information

Rheumatism in children is a systemic inflammatory disease of connective tissue due to the accumulation of uric acid salts in the blood. The disease most often occurs in children aged 7 to 15 years. Very rarely, children under the age of 3 fall ill and people older than 40 -45 years. It was established that the onset of the disease or its recurrence is preceded by angina, pharyngitis, rhinitis or scarlet fever, streptococci. The cause may be hereditary predisposition, although the disease itself is not inherited. In children, rheumatism has a significant tendency to acute, severe, flow. As a rule, the cardiovascular system is affected, and with each attack its damage is intensified. Treatment of rheumatism in children is carried out in a hospital, its duration is 45-60 days. The patient is provided with a treatment regimen depending on the activity of the pathological process and the intensity of heart changes. Food should be age appropriate.

Signs of rheumatism in children

All children who have suffered rheumatic fever, with the occurrence of acute respiratory viral infection, angina, sinusitis within 10 days are prescribed antibiotics and anti-inflammatory drugs. Rheumatism in children also affects the joints. The disease begins and age 2-4 years, sometimes in the first year of life. There are feverish condition, intoxication, swelling and tenderness of the joints, at first large( knee, elbow, ankle, hip).Then the neck part of the spine, wrist, jaw, and finger joints suffer. The defeat is symmetrical. The shape of the joints changes. They sometimes show a small amount of liquid. Children complain of soreness in the joints during movement, especially when extending. With repeated attacks, these complaints are more pronounced.

After the development of joint damage, it is possible to note atrophy and hypotonia of muscles. Simultaneously there are multiple muscle contractures. In advanced cases of rheumatism in children, bone tissue also changes. On the roentgenogram - signs of increased bone formation from the periosteum and at the same time its resorption. The periosteum that grows in the joint region, the granulation tissue leads to a change in the cartilage, which is the cause of the deformation of the joints and the surfaces of the bones. At the place of granulation, fibro-scar tissue forms, which leads to subluxation and dislocation.

Following the defeat of the joints in children, an increase in lymph nodes develops, which reach a maximum value within a few days. With the reverse development of the process in the joints, they decrease. Nodes are slightly painful, dense, not soldered to the skin, do not get stuck. The temperature curve is typically wavy in typical cases. The liver is enlarged by 2-3 cm, sometimes the spleen is enlarged. In the study of heart function, the tendency to tachycardia, myocardial dystrophy, is determined. In the blood - anemia, increased ESR, first leukocytosis, then leukopenia.

Treatment of rheumatism in children

Treatment is carried out in a hospital with observance in the acute period of strict bed rest, with the necessary care for the child. In the acute stage, antibiotic use is possible individually according to the indications. Non-steroidal anti-inflammatory drugs( acetylsalicylic acid, butadione, amidopyrine), antihistamines are used. Glucocorticoids are used in short courses for 1-2 weeks, prednisolone is more often used.

In children of school age, in the course of a severe course of the disease, indomethacin, brufen, immunosuppressants, deligil, and chloroquine are also used in the complex of therapy or, if necessary, for the abolition of glucocorticoids. In a complex of therapy use nonspecific stimulating agents - vitamins, physiotherapy, aloe, transfusions of blood plasma. From the beginning of recovery, therapeutic massage and gymnastics are used.

In the period of remission, sanatorium treatment is provided. Surgical correction is possible( consultation of orthopedic surgeon).The prognosis with active complex treatment is relatively favorable, but in the case of disease progression - serious. Polyarthritis is often combined with rheumatic heart disease. In the treatment of rheumatoid polyarthritis, children also benefit from traditional medicine.

Medical treatment of rheumatism in children: one of the antirheumatic drugs - amidopyrine or analgin for 0.15-0.2 g per year of life( no more than 2-2.5 grams / day);Acetylsalicylic acid - 0.2-0.25 grams / day per year of life. In recent years, more and more drugs are used such as methindol( indomethacin) and voltaren at a dose of 1-3 mg /( kg per day) alone or in combination with hormonal drugs. In a hospital, a sick child undergoes a course of treatment on average for 1.5-2 months, and then for 2, 3 months for stage treatment is sent to a sanatorium. After the sanatorium the child comes under the supervision of a pediatrician-cardiologist. The prognosis remains serious with modern methods of treatment, since even after the first attack, heart disease is formed in 10-15% of children.

Methods of treatment of rheumatism in children

Recipe 1 .Lay out on the linen sheet the young leaves of the birch, then lay it on the baby and swaddle, leaving only the heart region untouched. It is best to do this during a daytime sleep for 1.5-2 hours. Term of treatment is up to 2 weeks. One of the best means for treating rheumatism in children.

Recipe 2 .Fresh wormwood wormwood spread out in layers on a dense linen sheet, then roll it with this grass into a roll. Two people stand at the edges of the sheets and squeeze it out, like squeezing normally washed laundry. As a result, the sheet will become green from the wormwood juice. To wrap the child in this sheet for 1.5-2 hours.

Recipe 3 .If the baby complains of pain in the joints, you should make him a mattress from May hay. Sewing an ordinary bag of any suitable material, stuff it with hay and put it in a baby cot. If the child has hay fever, the May hay should be replaced with oat straw in green.

Recipe 4 .Smear all the child's body( except the heart area) with turpentine ointment, wrap a linen sheet, cover with a warm blanket and hold it for 15 minutes. If he is worried, the procedure can be shortened to 5 minutes. Turpentine ointment should be prepared as follows: 5 parts of unsalted porcine interior fat should be thoroughly mixed with 1 part of purified turpentine turpentine. Previously, this ointment should parents experience on themselves.

Recipe 5 .For the treatment of rheumatism in children mix 100 grams of swine-soaked interior fat with the contents of three jars of Vietnamese balm Golden Star, lubricate the baby with this ointment, bypassing the heart area, and wrap the baby with a soft sheet.

Recipe 6 .Bathe the child in an alkaline bath. To prepare it you need to collect clean wood ash, fill with water, boil, defend for the night or day. Pour into a bath, diluted with water. In the bath the patient should sit 10-15 minutes at a water temperature of 30-32 ° C and water should reach him to the stomach area. Alkaline baths should be used only on the advice of a doctor or specialist.

Recipe 7 .Collect the earthworms, wash them and put them in a glass jar, tie them with paper and put them on the sun for a few days. When worms dissolve, this solution spreads painful joints - there are not only pains, but also tumors.

Recipe 8 .To eat during illness it is possible milk in all kinds - fresh and sour, raw vegetables and fresh berries. Tomatoes and lingonberries are very useful. It is necessary to warmly dress and drink more liquid to cause the separation of sweat and urine.

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