2024-04-09 22:42:56
Aysor.am continues the series of publications dedicated to Juvenile Idiopathic Arthritis. By following this series, you will get to know the causes of this disease, symptoms, different forms of manifestation, types of the disease, features of treatment and care.
In this publication, we will talk about the diagnosis and treatment of Juvenile Idiopathic Arthritis.
What lab tests are needed?
At the time of diagnosis, certain laboratory tests, joint examination, and eye examination are necessary to distinguish the type of IIA, to identify patients who are likely to develop complications (such as chronic iridocyclitis). Among the important researches are:
– Rheumatoid factor presence or absence test, which is a laboratory test that detects autoantibodies (antibodies directed against one’s own body). A positive result and presence in high density indicates the YIA subtype.
– The anticorticosteroid antibody test (ANA), which is often positive in early-onset YIA oligoarthritis. In this group of patients with IIA, the risk of chronic iridocyclitis is high, so it is necessary to examine the eyes regularly (once every 3 months) with a slit lamp.
– HLA-B27 cell marker test, which is positive in up to 80% of patients with enthesitis combined arthritis. In healthy individuals, it is positive in 5-8% of cases.
– Other laboratory indicators, such as erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), are useful in determining the degree of inflammatory activity.
However, diagnosis and treatment are largely based on clinical signs rather than laboratory findings. Depending on the treatment, the patient may need periodic laboratory tests (eg, complete blood count, liver function tests, urine 1/16 test) to monitor the side effects of the treatment and to determine the degree of possible drug toxicity, which may be asymptomatic.
Joint inflammation is assessed primarily by clinical examination and sometimes by imaging modalities such as ultrasound. Periodic X-ray examinations or magnetic resonance imaging (MRI) allow to assess the condition of the bone structure and bone growth, and therefore also to correct the treatment.
How can we cure it?
For all types of arthritis, the goals of treatment are to relieve pain, fatigue, and stiffness, prevent joint and bone damage, reduce deformities, and improve mobility while maintaining growth and development.
Over the past ten years, there have been tremendous advances in the treatment of IA due to drugs known as biologic agents. However, some children may be “resistant to treatment,” meaning that despite treatment, the disease remains active and the joint inflammation does not go away. There are certain guidelines for treatment planning, although treatment must be individualized for each child. Parental involvement in the treatment decision is very important. Treatment is primarily based on medications that suppress systemic and/or joint inflammation and rehabilitative measures that maintain joint function and help prevent deformities. Treatment is multifaceted and requires the cooperation of various specialists (pediatric rheumatologist, orthopedic surgeon, physical and occupational therapist, ophthalmologist).
Follow our publications and get acquainted with the drugs used in the treatment of Juvenile Arthritis, as well as rehabilitation measures.
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