CAMAGÜEY.- Rheumatic diseases are a set of conditions where the inflammatory joint or periarticular process predominates, and is accompanied by other manifestations. They have been known for a long time, even several authors say that Hippocrates and Galen, professionals of antiquity, admitted them in very specific cases.

These ailments are also known as: connective tissue - a group of very diverse tissues, which share their function of filling and occupy the spaces between others and organs, and constitute the material support of the body and autoimmune, which your immune system attacks your body's healthy cells by mistake and these can affect many parts of the body.

The above definitions were offered by Dr. Tania Cristobo Bravo, 2nd Degree specialist in Pediatrics, Master in Child Care, trained in Rheumatic Diseases of Children, Eduardo Agramonte Piña pediatric hospital and Assistant Professor of the Department of Pediatrics of the University of Medical Sciences Carlos J. Finlay, of this city, who kindly received us very early in the morning.

—What are the most frequent diseases in childhood autoimmune diseases?

—The systemic lupus erythematosus and juvenile rheumatoid arthritis, juvenile idiopathic arthritis, juvenile chronic arthritis, are the different synonyms. In children, the most frequent is the oligoarticular that takes less than four joints, but usually repeats and after a successful treatment they can cure or enter long stages to make relapses or become chronic, although with a period of stability without major changes .

—How do they appear?

— Suddenly.

—What are they related to?

- With hereditary factors, infections and environmental. Therefore, if you carry this genetic load in your body, it makes it possible for an infection or certain environmental exposures to be more susceptible to triggering it.

“It is good to know that among autoimmune diseases they can be systemic (they affect many organs) or specific organs, and among these we find some very well known as: diabetes mellitus, autoimmune hepatitis, multiple sclerosis that affects the central nervous system.

"It is the same with psoriasis, which associated with arthritis leads these infants to psoriatic arthropathy - joint disease that occurs in approximately 10% of patients suffering from psoriasis."

"Systemic lupus erythematosus is another way of presentation, because it attacks different organs and tissues and also the joints."

- Do you think there is awareness that rheumatoid arthritis can occur in children?

- It is generally thought that it is an adult disease, and in fact it is a regular suffering in pediatric ages.

—Does it have a predilection for gender and skin color?"

—It predominates in girls, while not related to skin color.

—Do they arise at specific ages?

—It is common between the first and third years of life, which does not exempt from being present at age nine and even in the adolescence stage. In the case of the idiopathic youth, it is linked to a series of environmental elements even with the stress maintained, as can happen due to the divorce of the parents, too much academic demand on the part of the family, and the same as bullying, which is the physical or psychological harassment to which they are subjected.

— Any difference between that suffered by children and that of adults?

—It differs in the presentation status. In children, it sometimes appears dramatically, which is its systemic form and they are taken to the doctor for severe anemia, fluids in virtual cavities, such as pleural, pericardial ..., and, in addition, inflammations of the liver, spleen, ganglia and viscera.

—Does it only appear in joints?

- No, it affects soft parts that include the muscles, tendons, with a lot of pain and inflammation.

—What would be the prognosis?

—Though the appalling of this painting has good control through treatment.

-Does it is cured?

—Yes, in 60 to 70% of cases. In about 30% they can be serious. Those that appear at an early age are disabling, with eye conditions that can lead the child to blindness.

"In other cases it depends on the positive or negative rheumatoid factor, an antibody that is determined in the blood, in the first case mentioned it affects much more, not forgetting that those children with the disease at an early age reach adulthood with osteoporosis joints, deformities, and some have to go to prostheses of certain joints. ”

-How is it diagnosed?

- Eminently through the clinic. There is no complementary test to validate it. The studies are rather aimed at ruling out other causes. And the investigation of the positive rheumatoid factor would be the only one to include and, in these cases, they are very disabling; however, in children only between three and 10% is affirmative, unlike adults, which does not mean that other imaging investigations are not done. It does not always appear in the same way, sometimes it gives a recurrent fever without apparent cause, pain, fatigue, nodules, damage at the level of the cartilage and skin lesions of the vasculitis type.

—Are children brought on time?

—Yes, and on certain occasions they are treated by orthopedics, ophthalmologists, cardiologists and other pediatric specialists, who refer them to these consultations because they do not respond to treatments. Moreover, eye conditions in children suffered for months and years, such as uveitis, can then be the product of the joints.

- Being this way, so difficult, how do you face the condition?

—We have a multidisciplinary team. We do inter-consultations with immunologists, cardiologists, gastroenterologists, neurologists, endocrinologists, ophthalmologists, physiatrists and psychologists.

—Can it be prevented?

-No. The genetic code here prevails that it is favored after certain infectious or environmental expressions.

—What would be the orientations to the parents?

—If the first-line family suffers from any of the autoimmune diseases, we must be vigilant, and avoid junk food in children, take care of psychological or psychological conditions, and the pressure of demand in studies and others, so that genetics do not be provoked from the outside.

"If they already suffer from it, do not forget to see them with psychologists because they are limited for sometimes long periods, by not leading a life like others of their age, or in schools."

• Translated by Linet Acuña Quilez