Did you know children can experience Juvenile Arthritis? Dr Pradeep Mahajan explains joint problems in kids – PINKVILLA

An umbrella term for a group of chronic childhood arthritis of unknown cause, in children below sixteen years of age, and persisting for at least six weeks

Juvenile arthritis (JA) is an autoimmune disease, which means the immune system of the body attacks the cells of the joints and causes swelling and cartilage/bone damage. The condition is not a single entity but an umbrella of inflammatory and rheumatic diseases, and in instances, the cause is unknown (idiopathic JA)

Diagnosis:

As we do not think that arthritis could occur in children, JA commonly goes unnoticed until advanced stages. In such situations, children experience severe pain and restriction of joint movements. In early stages, pain due to JA is typically dismissed as “growing pains” or injury while playing.

In fact, statistics suggest that approximately 300,000 children in the USA are affected by JA. In India, the guess estimates of JA are based on worldwide statistics of 0.07-10/1000 individuals. We could assume that approximately 1.3 million Indian children suffer from the condition. More so, a significant number of these cases progress to adult arthritis. There is another variant called Systemic Juvenile Idiopathic Arthritis, which is associated with spiking fevers for more than 2 weeks, accompanied by at least one of the following: an evanescent rash, arthritis, lymphadenopathy, serositis, or hepatosplenomegaly. The incidence of this condition, as per crude estimates in India is 8%-24% of patients with JA.

Diagnosis of JA:

– Clinical pattern recognition

– Clinical pattern recognition

Treatment:

Conventional treatment involves pain medications, steroids, disease-modifying agents, vitamin supplements, etc. to control the symptoms, inflammation, and slow the course of the disease. This is combined with physiotherapy and even surgery in extreme cases. The issue is that the affected child does not get treated completely and tends to develop systemic manifestations with time as well. Thus, life-long medications and rehabilitation is indicated, without significant improvement in function, which affects the overall quality of life of the patient.

Aims of Treatment: 

– Control symptoms

– Prevent joint destruction and long-term disability

– Promote growth and development

– Recent advances in treatment

– Anti-cytokine therapy

– Immunotherapy

– Immunotherapy

– Exosomes

Exosomes are membrane vesicles secreted by most cells. Think of these as packets of cellular material that are released into the blood when required for various functions. These exosomes are capable of modifying the immune system; therefore, they could be beneficial in the treatment of JA. They can also reduce inflammation, which would be a boon to reduce the symptoms as well as prevent further tissue damage in children. These molecules are present in the body and are not affected by the disease. Furthermore, standardized exosomes can be developed in laboratory settings in high quantities and can also be obtained from allogeneic sources. Exosomes do not contain any DNA, cell membrane, or organelles. Thus, treatment with these molecules is safe, effective, and minimally invasive. Of course, rehabilitation is required to enhance treatment outcomes; however, with this combination approach, children will be able to lead a healthy life free of joint disease.

“We are witnessing rapid advances in targeted molecular therapies. These are changing the treatment dynamics of conditions such as JA, which is yet unknown to many. Through such molecular therapies, we can ensure long-term results, along with the regeneration of damaged tissues, and not repair (which is temporary). Children with JA should be able to live a life free of pain with freedom of movement and treatment with exosomes could lead the way to achieve that target,” says Dr. Mahajan.

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