Definition and causes
Børnegigt is an overall term for several types of ledlidelser in children and adolescents. For that we can talk about børnegigt, there must have been the pain in one or more links in more than 6 weeks without any known cause. Depending on the type børnegigt, there is, there may be symptoms of more than part like. eyes or skin.
The reason for børnegigt is not known in detail, but there is a kind of betændelsesreaktion in the joints and in some cases also in bindevævet. Betændelsestilstanden is not due to bacteria or viruses. For most types børnegigt to the fact that girls are affected twice as often as boys. Børnegigt is rare. There are about. 800 children with børnegigt in Denmark, and every year around. 100 children diagnosed.
The various subtypes are:
- Oligoartikulær(get the context involved, oligo = few, artikulatio = part), representing 40%.
- Polyartikulær(many layers involved, poly = many), is 25%.
- Systemic(the whole body involved), is 10-15%.
- Entesopatirelateret(related to senetilhæftningerne = enteser) and
- Associated with psoriasis .
Symptoms of børnegigt
Frames usually girls aged 2-4 years. Showing atpain, redness and swelling, 1-4 context.It is most often on the large part, such as. knee joint. The majority (70-80%) have a specific antibody, ANA (antinukleært antibody), In the blood. Some of these are developing inflammation of regnbuehinden and about. 1 / 3 sheep after 6 months problems with more than 4 parts.
Frames usually children of 2-4 years of age and before puberty. Showing atpain, redness andswelling in more than 5part within the first 6 months. Ledpåvirkningen is usually symmetrical, and the affected part is most often knee, wrist, fodled, fingrenes inner part and neck-and kæbeled. 80% haveIgM reumafaktorin the blood, which is also seen in many patients with RA . 90% of these are girls over 10 years, and ledproblemer developing rapidly and aggressively as RA . Many have small lumps in the skin usually by the elbows and part develops chronic inflammation of regnbuehinden . A large part has also ANA in the blood.
Typically, long jumping fever (less than 14 days), which bills such that at the same time each day isfebertoppe. Furthermore, anon-itchy lakserødt, blotchy rash, The most widespread in strækkesiden of arms and legs and on the side of the upper body. Udslættet followed with fever, and worst, when the fever is high. There may beswollen lymph nodes, As well as liver and spleen may be magnified. There may bechest painoften worsened by deep breath, and if you are sitting foroverbøjet. The mosteasy tenderness of the musculoskeletal, But only when the other symptoms have been present in the weeks to months, there will be realpain with swelling, heat and redness over the joints. Not everyone gets symptoms from the joints. The symptoms goods usually week-months and often after a period without symptoms.
Frames usually boys over 9 years. Showing atirritation, redness and swelling at the senetilhæftninger, Usually by akillessenen, and the pain in the hip, lænderyg, knee and fodled. 50-60% have a specific genetic vævstype, HLA-B27, which increases the risk of certain gigtlidelser also in adulthood.
Frames a little more often girls. Displays aspain, redness and swelling in one or more linksof a person who already has psoriasis or finger-or negleforandringer compatible with psoriasis or close relatives with psoriasis.
The affected part is often large part, and the pattern of involved joints are asymmetrical. Some have ANA in the blood, and from those seen chronic inflammation of regnbuehinden .
Precautions and diagnosis
The symptoms of børnegigt should go to the doctor, who may. will refer to the pediatrician. It can be difficult to make the diagnosis børnegigt, because the symptoms often come and go and may vary somewhat from child to child. For that we can talk about børnegigt, ledsymptomerne have lasted for at least 6 weeks, without any known cause it.
The doctor will take some blood tests that can assess the activity of the disease (sænkningsreaktion, C-reactive protein, haemoglobin, white blood cells, platelets and antibodies), and some are used to classify the disease in different subtypes (ANA, reumafaktor , Anti-DNA). Røntgenbilleder or ultrasound of the involved part may show different typical change.
Consideration of børnegigt
Treatment depends on the subtype of børnegigt, there is, the child's age and whether there are complications. Basisbehandlingen are:
- Analgesics medicines, mostly in the form of NSAIDs (non-steroid anti-inflammatory-drugs).
- The injection of binyrebarkhormon directly into the stage.
- Checking with eye around. 3 each. months during the first few years of illness. The signs of inflammation of regnbuehinden shall be given eye drops containing binyrebarkhormon and a pupiludvidende substance to avoid the sight impaired.
- Checking with specialtandlæge: If kæbeleddene involved, you get a special bideskinne.
By the polyartikulære and systemic type can be a special kind of long-gigtmedicin (DMARDs =disease-modifying anti-rheumatic drugs) Given for many years, typically until a few years after the symptoms have disappeared. For the polyartikulære type can also be usedmethotrexate(a type of chemotherapy) in the low dose or a newer product calledTNF inhibitor.
Select and complications
Monitoring of børnegigt depends on which subtype it is all about. Often seen a course where there is both good and bad periods. Best is it for the children who have arthritis in a few part, where most will not have ledproblemer later in life. However, a part of the vision impairment due to inflammation of regnbuehinden . Of the children who have the polyartiklulære or systemic gigttype, almost half still have symptoms after 10 years.
The complexity is, in addition to poor joint function, eye problems in the form of inflammation of regnbuehinden . This may later lead to both cataract and glaucoma , Which in turn can lead to poor vision or any. total blindness. The involvement of kæbeleddet can cause disruption of the growth of the lower so that the latter is small and retracted.