Juvenile Idiopathic Arthritis (JIA): Symptoms, Causes and Treatment
Do you associate arthritis with old age? Read about juvenile arthritis, an autoimmune disease that affects young children and make their movements painful, depriving them of a normal childhood.
By Dr Priyanka Kharbanda
10-year-old Sudeshna often suffers from pain, swelling and stiffness in the joints. To the utter shock of her parents, following visits to the doctor and some tests, she was diagnosed with Juvenile Idiopathic Arthritis (JIA). This makes it almost impossible for her to lead a normal childhood.
Yes, children get arthritis too! We always associate arthritis with old-age and adults. But even young children, such as Sudeshna, under the age of 16, could suffer from arthritis. Also known as Juvenile Rheumatoid Arthritis and childhood arthritis, this condition could affect the quality of life of children, as it restricts their movements.
If your child has symptoms like constant pain, stiffness or inflammation of the joints without any obvious reasons, don’t dismiss it as another bout of growing pain. It could be Juvenile Idiopathic Arthritis (JIA). Consult your doctor immediately.
What is Juvenile Idiopathic Arthritis?
Juvenile Idiopathic Arthritis is an autoimmune disease that causes swelling of the tissue that lines the inside of the joints. It can affect children aged 16 or younger.
What is an autoimmune disease?
An autoimmune disease is a condition where our own immune system mistakenly attacks our body. Normally, our immune system fights against foreign bacteria and viruses. But, in this case, it mistakes our body organs – particularly the bones and joints – for foreign particles, and attacks them.
Causes of JIA
‘Idiopathic’ means there is no specific cause for the disease. The medical fraternity is still not on agreement on the reasons for JIA. Some researchers state that both the environment and heredity cause the condition. Others believe that certain genetic mutations might make a child more vulnerable to this condition. The genetic make-up of the child could make him susceptible to microbes that can trigger JIA. Some children carry the disease till their adult years.
Also read: Can Children Be At Risk Of Heart Diseases?
Symptoms of JIA
Pain, stiffness and swelling of the joints are common symptoms of the disease. Some children may experience the symptoms of the disorder for a few months, while others can have the symptoms for the rest of their lives. The onset of JIA also varies — some children get it as early as one year, while there are instances of children getting it around ten years. Young girls are more likely to get it than boys.
Watch out for these symptoms in your child:
In the joints –
- Pain: Pain in the joints, mostly in the lower body, is one of the most common symptoms of the condition. Some children may limp because of joint pain. However, not all children complain of pain.
- Swelling: The joints may be reddish, inflamed and have reduced functionality. If you notice swelling in your child’s knee, check with her if she feels any discomfort.
- Stiffness: Many children who have JIA experience stiffness. They may also feel lethargic.
In other parts of the body –
- Some children may also get swollen lymph nodes and rashes on the chest, abdomen and back.
- Other symptoms: In severe cases, JIA could lead to breathlessness, increased heart rate, redness of the eyes and loss of vision. Some children may experience rapid weight loss.
Here are some of the complications which may arise due to JIA:
- Growth problems — Chronic diseases in childhood often impact growth in children. Not just the disease but the drugs used to control inflammation, such as steroids, can also permanently stunt the height of children. The best strategy to maximise growth is aggressive disease control, nutritional support and judicious yet minimal use of steroids.
- Deformities — Unlike adults, children with arthritis have a growing skeleton and are, therefore, vulnerable to developing deformities.
- Osteoporosis — JIA decreases physical activity in children. This, in addition to usage of drugs like steroids, may lead to osteoporosis. Children with JIA also suffer from low levels of vitamin D and calcium. As a result, they have low bone mineral density. To deal with osteoporosis and other related diseases, such children have to take calcium supplements. Also, encourage these children to engage in whatever physical activity is comfortable for them.
The diagnosis of JIA is done mainly through blood tests. Sometimes, imaging tests such as X-rays and MRIs are also recommended. These tests help to detect congenital defects, fractures and tumours.
Treatment for JIA is about managing the symptoms of the disease. Doctors, especially try to save the bones from getting damaged.
Diet: Generally, there are no restrictions on food. However, some children may need to undergo some dietary changes to manage the condition.
Medicine: Medication is given to lessen the pain associated with the condition.
Therapy: New therapies help treat children with JIA more effectively and even induce remission in many of them.
Note: Use of steroids for treatment should be minimal.
Further, disease education is a must for the family and the child with arthritis. And, remember, treating a child with JIA is a team effort, involving a rheumatologist, physiotherapist, nurse and an ophthalmologist.
Juvenile Idiopathic Arthritis is a painful condition in young children. More awareness about the disease is the need of the hour. Affected families must come together to manage the condition in young children better. All it needs is lots of love and patience.
Dr Priyanka Kharbanda is a Senior Consultant, Rheumatology, in a leading hospital in Delhi.
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