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ORIGIN, DIAGNOSIS AND MODERN CLINICAL DIAGNOSTIC METHODS OF
RHEUMATISM
¹Ubaydullaev Rustam
²Xoliqov Otabek Temirxon oʻgʻli
³Xushvaktov Anvar Ikrom oʻgʻli
¹Assistant Professor, Department of Clinical Pharmacology,
Samarkand State Medical University
²
.
³Samarkand State Medical University, Faculty of Pharmacy, Group 512 students
https://doi.org/10.5281/zenodo.14781891
Abstract.
Rheumatism in children is an acute disease of an infectious-allergic nature,
manifested by persistent damage to both joints and other structures: heart, lungs, liver, skin,
organs of vision and other div systems. The condition is systemic in nature, has a tendency to
relapse and can cause complications that threaten the child's life. Evaluation of the symptoms,
diagnosis, treatment and prevention of rheumatism in children is carried out by rheumatologists
with the participation of pediatricians, infectious disease specialists, allergists and other
specialized specialists.
Keywords:
Classification, Causes of the disease, Symptoms, Diagnostics, Treatment,
Prognosis, Prevention.
Introduction
Symptoms of childhood rheumatism are most often detected in children aged 6 to 14 years.
The onset of the disease is acute, in most cases associated with a recent or still active streptococcal
infection. The prevalence of this pathology does not exceed 0.3% per thousand children, but
rheumatism remains one of the most common culprits in the development of acquired heart defects.
Rheumatism in children
Taking into account the severity of clinical manifestations, experts distinguish three stages
of the disease:
a.
the first is characterized by mild symptoms;
b.
the second is accompanied by moderate demonstrations;
c.
the third is pronounced, with a multiplicity of symptoms and a sharp deterioration
in the child's well-being.
By the nature and characteristics of the course, active and inactive phases of rheumatism
are distinguished. Active is characterized by pronounced clinical signs, including high fever,
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general intoxication, pain in the joints and muscles, cardiac dysfunction, etc. The inactive stage is
the period between exacerbations, which in some children is accompanied by mild malaise and
low-grade fever.
Taking into account other parameters, rheumatism of an acute, subacute, protracted,
persistent and latent nature is also distinguished. Depending on the area of the greatest damage,
they distinguish:
the nervous form of the disease, when symptoms of neurological and psycho-emotional
disorders come to the fore;
articular form, in which symptoms of damage to the joints of the ankle, knee, hand, etc. are
aggravated;
heart shape, if the child has symptoms characteristic of serious cardiovascular pathologies:
shortness of breath, rapidly increasing fatigue, tinnitus, high blood pressure, etc.
There are several other classification options that divide individual types of rheumatism
into groups, taking into account morphological, etiological and other parameters.
Causes of the development of the disease
The main culprit of the pathology is an acute streptococcal infection caused by group A
pathogens.
Глава 1
angina;
Глава 2
red fire;
Глава 3
pharyngitis;
Глава 4
chronic tonsillitis.
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These conditions increase the activity of the immune system, which begins to produce
special antibodies to suppress streptococcus. Antibodies recognize pathogenic molecules with the
help of a special protein, but since the connective tissue of many human organs contains a similar
substance, the div's own cells are also attacked. As a result, an autoimmune inflammatory process
develops.
The cause of the development of the disease in children and adolescents is also a hereditary
predisposition, if one of the parents or other close relatives has previously suffered from
rheumatism.
Risk factors that increase the likelihood of developing pathology:
a.
frequent stress;
b.
systemic hypothermia of the div;
c.
improperly selected or delayed treatment of streptococcal infections;
d.
lack of certain vitamins, macro- and microelements in the child's div;
e.
poor nutrition;
f.
the presence of other autoimmune diseases (systemic lupus erythematosus,
psoriasis, erythema nodosum, etc.).
Streptococcal infections are most dangerous for children with any systemic pathology, who
suffer from chronic fatigue, who are sleep deprived, poorly nourished, and who experience great
physical and mental stress.
Symptoms
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The clinical presentation of rheumatism is diverse, and the symptoms are variable,
depending on the form, stage, and severity of the condition in children. As a rule, the manifestation
of the disease occurs 1-4 weeks after the end of the streptococcal infection.
The main symptoms of childhood rheumatism:
a.
pain, discomfort in the joints;
b.
deformation of articular joints;
c.
swelling, redness of the skin in the area of the affected joint;
d.
weak muscle tone;
e.
high blood pressure;
f.
tinnitus;
g.
shortness of breath, worsening during meals, after physical activity, climbing stairs
or uphill, with excitement;
h.
lethargy;
i.
fatigue;
j.
with an increase in subfebrile div temperature.
The main feature of rheumatism in children is a specific lesion of the heart system
(rheumatic carditis), which is observed in almost 100% of cases. Symptoms include:
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a.
heart pain of varying intensity;
b.
heart rhythm disturbances from fast to slow pulse;
c.
difficulty breathing;
d.
cough;
e.
enlargement of the liver, causing heaviness in the right hypochondrium.
Rheumatism, which occurs with rheumatic carditis, causes swelling of the legs, swelling
of the face, and paleness in children.
Often the disease is complicated by polyarthritis, which affects large articular joints. The
condition is accompanied by severe pain, limited mobility, initial pain, etc.
A characteristic symptom of rheumatism in children and adolescents of primary school age
is erythema annulare. This is a specific rash on the skin of a light pink color in the form of rings,
localized on the chest and abdomen.
Diagnostics
Suspecting rheumatism requires a complete examination of the child, which begins with a
general physical examination. The pediatrician or rheumatologist assesses the condition of the
skin, identifies signs of annular erythema and inflammatory joint lesions, conducts auscultation of
the lungs and heart, and performs a number of physiological tests.
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In the future, to select the optimal algorithm for the treatment of childhood rheumatism and
to distinguish the symptoms of the disease from other diseases with similar symptoms, the
following is carried out:
a.
general clinical, biochemical, immunological and serological blood tests;
b.
chest x-ray;
c.
ultrasound examination of joints, liver, heart, kidneys and other systems;
d.
electrocardiography, phonocardiography, echocardiography;
e.
computed tomography or magnetic resonance imaging.
Consultation with pediatricians is mandatory: neurologist, ophthalmologist, cardiologist,
nephrologist and other doctors.
Treatment
Like other diseases, rheumatism in a child should only be treated by a qualified medical
professional. It is impossible to use unconventional therapy methods or traditional methods for
this pathology, since the risk of irreversible changes in the div, including death, is very high.
Treatment should be comprehensive and continue until a clear remission is achieved.
Specific tactics are selected based on the stage of the pathological process and clinical symptoms.
Children with rheumatism in the acute stage require hospitalization and subsequent
inpatient observation. Complete motor rest, a strict diet, and strict adherence to medication
regimens are indicated. NSAIDs, corticosteroids, and quinoline drugs are used as needed to reduce
the activity of the inflammatory process. To suppress streptococcus, broad-spectrum antibacterial
agents are optimally prescribed after testing the sensitivity of bacteria to the main active ingredient
of the drug.
Children with rheumatic diseases in the inactive stage are shown restorative courses of
treatment in a sanatorium or in a special rehabilitation clinic. To improve well-being and
strengthen the div as a whole, gymnastic exercises, swimming, therapeutic exercise classes, mud
therapy and other physiotherapeutic methods are prescribed.
If children have other chronic or acute pathologies, the treatment of rheumatism is built
taking into account all the symptoms, the possibility of combining medications, and the other
health conditions of young patients.
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Research results:
In 20% of cases, primary episodes of rheumatism lead to the formation of heart defects.
Secondary lesions almost always cause significant damage to the valvular system of the heart,
which subsequently requires surgical treatment. In general, the prognosis is determined by the
stage, form and clinical picture of the disease, and also largely depends on the adequacy and
timeliness of treatment.
Conclusion
To reduce the risk of developing rheumatism in childhood, experts recommend:
to carry out vaccinations for children;
do not treat acute infectious diseases independently at home or with traditional methods,
always seek help from doctors;
to provide children with adequate physical activity appropriate to their age and activities;
monitoring children's nutrition, maintaining a balanced diet;
regular sanitization of chronic inflammatory foci in the div.
Children with diseases of the joints and cardiovascular system should be constantly under
the supervision of a doctor, undergo regular preventive examinations, and take the necessary
medications.
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