Acıbadem Maslak Hospital Pediatrics, Pediatric Rheumatology Specialist Assoc. Dr. Ferhat Demir explained 8 symptoms of rheumatic diseases in children, gave warnings and suggestions.
Demir made the following suggestions about pediatric rheumatism:
“The most common finding of rheumatic diseases in children is joint complaints. Pain in any joint, accompanying difficulty in moving, redness-heat increase on the joint skin or a visible swelling in the joint may be the first sign of a temporary or permanent rheumatic disease. Especially if these findings are not short-lived or recurring, the child should be evaluated without delay.
Fever is an indicator of the activation of the immune system after stimulation for different reasons and the reaction to the protection of our body. If there is no infection that can cause this fever, rheumatic fever should also be evaluated. PFAPA syndrome (recurrent fever) and Familial Mediterranean fever (FMF) disease are the most common causes in our country. In these diseases, one or more of the findings such as recurrent fever, abdominal pain, chest pain, throat infection, rash, diarrhea and enlarged lymph nodes can be seen with certain periods (between 1/2 weeks and 3/4 months).
When it is determined that the fever is not caused by infection, rheumatic diseases with fever should be evaluated in the diagnosis. A vascular rheumatism called Kawasaki disease should be considered in the diagnosis of fever lasting 5 days or longer, and febrile joint rheumatism in the case of fever lasting 2 weeks or longer. ”
Pediatric Rheumatology Specialist Assoc. Dr. Ferhat Demir said, “Complaints of resistant fever, tonsillitis (tonsillitis), pharyngitis, aphthae-wound in the mouth and enlarged lymph nodes in the neck, recurring at an average of 3-4 weeks are the findings of PFAPA syndrome. Unfortunately, these findings can often be confused with a throat infection and patients may receive unnecessary antibiotic treatment.
In case of recurrent or prolonged muscle weakness-muscle pain, children should be evaluated for rheumatic diseases.
Rheumatic diseases can present with different types of skin rashes. One of the most common is an itchy skin rash called urticaria (hives), which may fade during the day. These rashes can be a sign of rheumatic disease, especially in the presence of fever. In addition, the presence of subcutaneous hemorrhage foci of different sizes, which we call petechiae or purpura, which can recur in different parts of the body, is also one of the symptoms of rheumatic vascular diseases, which we call vasculitis. The mottled appearance of the skin, called Livedo reticularis, may also be the first sign of a rheumatic vascular disease. Recurrent oral ulcers-aphthae may be a sign of an underlying rheumatic disease, or they may develop completely benign. In addition, mouth sores may occur due to anemia and vitamin deficiencies. Rheumatic and/or intestinal-related diseases such as Behçet's disease, PFAPA syndrome, Celiac and Crohn's disease can cause recurrent mouth sores. Children who have more than 3-4 mouth sores a year should definitely be evaluated in these aspects.
Recurrent abdominal or chest pain conditions that occur at different periods may develop on the basis of rheumatic diseases with fever, which we call periodic fever syndrome. Familial Mediterranean fever is the most common of these diseases in our country and should be kept in mind in cases of abdominal pain for which the cause cannot be found.
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