Juvenile Arthritis

June 21, 2017

Most people think arthritis only affects older people, but that is far from the truth.

Juvenile Arthritis has become a chronic childhood illness. About 300,000 children in the United States are diagnosed with arthritis. Typical symptoms include inflammation (swelling), joint pain, stiffness and tenderness. Morning time limping is also an early sign of juvenile arthritis.

Rheumatologist and FDA clinical team leader Nikolay Nikolov offers hope for those who have juvenile arthritis. Over the past few years, drug companies have been developing new treatments that can control the disease and its effects, which may reduce the onset of physical disability in later adult years.

The cause of juvenile arthritis is unknown, but what scientists do know is it is an autoimmune disorder in which the immune system attacks its own body tissue.

Juvenile Idiopathic Arthritis (JIA) is the name known for the collective group of conditions classified as juvenile arthritis that start before age 1 and has symptoms lasting for at least 6 weeks.

The wrists, ankles, knees and even smaller joints are impacted by JIA. Polyarticular JIA is the largest JIA subgroup because it impacts several joints. Systemic JIA is another subgroup that impacts the entire body and can cause skin rashes and fever.

Past treatment for juvenile arthritis included NSAIDS (non-steroidal anti-inflammatory drugs) like aspirin and ibuprofen. Corticosteroids and methotrexate are used in more severe cases to suppress immune response to the joints.

FDA-approved biologics (medicines originating from biological sources) are now being used to treat both systemic and polyarticular JIA.

Current JIA Treatments

Because of advanced science, doctors are now able to determine what encourages the occurrence of arthritis. Cytokines (molecules responsible for inflammation control in the body) like interleukins (IL), tumor necrosis factor (TNF) and other natural proteins that facilitate immune responses are the focus of new medicines.

Biologics are administered intravenously or subcutaneously (under the skin) over the course of several years to maintain symptom relief.  Not all biologics work the same on all subgroups of JIA.

Currently, there is no data on the long-term effects of these newer medications on children, but there is a lot of information on how these drugs affect adults with rheumatoid arthritis (RA). One also should be mindful that biologics suppressing the immune system can increase the risk of infections like tuberculosis in children.

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All of us have had problems remembering something—like where we last put our car keys or where we last placed our glasses.

These occurrences are normal because the brain is always trying to sort, store, prioritize and retrieve information.  But where do we draw the line between normal memory loss and abnormal memory loss? The following checklist should help you make the distinction:

  • Does the memory loss interrupt your daily lifestyle (doing personal hygiene, balancing a checkbook and driving)?
  • Are there signs of confusion? Serious memory problems cause people to be lost even when they are in places they know. They may also move items to inappropriate locations (like putting deodorant in the refrigerator).
  • What’s being forgotten? The extent of the memory loss is another sign. When people start forgetting entire conversations, there’s a problem. Another sign is forgetting the names of people close, such as family and friends or repeating the same information in the same conversation.
  • How often do memory lapses occur? Forgetting where you parked every now and then is normal, but to forget your parking spot where you always park is abnormal.When you start forgetting regular appointments and events, those are signs your memory problems are disrupting your daily functions.
  • Is the memory loss getting worse? If it seems like the memory lapse episodes are occurring more frequently, then you need to seek medical help to get examined.

What Causes Memory Loss?

Anything that can impact mental functions—thinking, remembering and learning—can affect memory.  Therefore, doctors must employ a variety of strategies to determine what’s happening to cause the memory loss.

Medical history, neurological and physical exams, blood tests and urine tests are all used to help determine the cause. Computerized axial tomography (CAT) scans or magnetic resonance imaging (MRI) are brain imaging tools used to rule out tumors and strokes, which can also affect memory.

All these strategies are used to rule out other more dangerous causes of the memory loss. Some causes of memory loss happen alone or in combination with other causes:

  • Stress, especially the kind related to emotional trauma, can impact the ability to remember. In rare instances, patients can develop psychogenic amnesia, which causes wandering and an inability to remember one’s own identity. However, this condition does leave on its own over time.
  • Excessive use of alcohol creates vitamin B1 (thiamine) deficiency, which can create memory loss. Drug abuse can also impact the chemical makeup of the brain and impact memory.
  • Medications: prescription and OTC over-the-counter) sleeping pills, antihistamines, antidepressants, certain medicines used to treat schizophrenia, some post-surgery pain medications and anti-anxiety medicines can impair memory.
  • A blow to the head can cause temporary memory loss that gets better over time. More severe cases like frequent head blows (from boxing and football, for example) can create progressive and more long-term memory loss with a host of other conditions.
  • Depression, especially in the elderly) can create a decrease in focus and attention that may impact memory.  Anti-depression treatments will change the person’s mood and improve memory.
  • Deficiencies of vitamins B1 and B12 can cause memory loss, but the deficiencies can be remedied with injections or pills.
  • An overactive (or underactive) can interfere with remembering recent events.
  • Poor sleeping habits can have a negative impact on your memory.
  • HIV, tuberculosis, syphilis, herpes, and other infections affecting the lining or substance of the brain can create memory issues.