Rheumatism in children

Adults are accustomed to consider rheumatism a disease affecting only the joints, but this disease primarily affects the heart, which is especially dangerous if it develops in childhood. Parents should know how rheumatism is manifested in children, how it threatens the child and how it is diagnosed.

Rheumatism is a disease of an infectious-allergic nature, in which the cardiovascular system is damaged. This disease is characterized by recurrent and progressive course, as a result of which the child develops heart defects.

The development of rheumatism in children is due to the activity of hemolytic streptococcus A. Enzymes secreted by this type of bacteria are toxic to the heart tissue. In addition, such microorganisms have antigenic substances similar to heart tissue, which is why the child's body attacks the heart, confusing it with an infectious agent (an autoimmune reaction develops).

There is an active phase of rheumatism, when the disease is manifested by severe symptoms, as well as an inactive, during which there are no clinical manifestations. In the active phase, three degrees are distinguished - minimal, moderate and severe disease activity.

Rheumatism can occur acutely (up to three months) or latently (heart disease is formed without a pronounced clinic). They also secrete a subacute course (3-6 months) and prolonged rheumatism (the duration exceeds 6 months). In some children, the disease continuously recurs for a year or more.

You can learn more about rheumatism from the following videos.

Most often, rheumatism develops at school age in the form of an acute attack, which is manifested in febrile temperature and symptoms of intoxication. As a rule, 2-3 weeks before an attack in a child, a respiratory disease is detected. Simultaneously with the fever in babies, pain in the joints (often large and medium) and their inflammation are observed.

The heart muscle in the acute phase of the disease becomes inflamed (rheumatic myocarditis develops), which is indicated by the following symptoms:

• Weakness.
• Pallor of the skin.
• Increase or slow heart rate.
• Expanded borders of the heart.
• Deaf or forked tones.

The first attack in children can affect not only the joints and the heart, but also other organ systems. Some babies see skin lesions in the form of erythema or the appearance of subcutaneous nodules, abdominal pain, involuntary movements of the limbs due to damage to the nervous system (they are called minor chorea). In chorea, movement disorders are accompanied by emotional disturbances.

Recurrences of the disease begin acutely and proceed with the same symptoms as the first attack. In this case, the main symptoms depend on cardiac pathology. Rheumatism most often causes the formation of such defects:

• Mitral valve insufficiency.
• Aortic valve insufficiency.
• Mitral stenosis.
• Stenosis of the mouth of the aorta.

To identify rheumatism in a child, its clinical symptoms and examination results are evaluated, which are divided into basic and additional criteria.

In clarifying the diagnosis using these methods of examination:

• Blood test - general, biochemical, immunological.
• X-ray of the chest.
• Electrocardiography.
• Echocardiography.

In the acute period, the disease is treated in the hospital because the child needs bed rest. Drug treatment includes antibiotics, anti-inflammatory drugs (including hormonal in severe cases), potassium supplements, vitamins and other medications. The child stays in the hospital for 1.5-2 months, after which the rehabilitation period passes.

Nowadays, the benign course of rheumatism is increasingly noted, especially if treatment is prescribed in the first days of the onset of an attack. The prognosis affects the damage to the heart, because in 10-15% of babies the valves are affected after the first attack, and each repeated one increases the risk of damage.

In order to prevent the development of rheumatism in childhood, it is important to exclude situations of infection of the child with streptococcal infection. Such prevention is called primary and includes:

• Full nutrition.
• Tempering procedures.
• Moderate exercise.
• The optimal mode of the day with enough rest.

You can learn more about children's rheumatism from the following video.