Rheumatism - a disease of children and adolescents, all of which the effects of which a person fully aware only in adulthood.
Rheumatic fever is a systemic inflammatory disease that develop as a complication of streptococcal illness nasopharynx nature, primarily involving the connective tissue and the localization of the main process in the cardiovascular system. The disease usually occurs in children aged 5 to 15 years, due to insufficient okripnuv immunity. If the disease begins to manifest active at an older age, then, according to experts, the first attack of rheumatic character was erased was not recognized.
Features of the development of rheumatic process
When you get into the body of streptococcus in the palatine tonsils, angina (tonsillitis) develops. This activates the immune system and the body begins to produce antibodies that fight infection, but because of the shell streptococcus includes specific M protein that is very similar to proteins contained in heart tissue and joints, after the destruction of pathogenic microorganisms antibodies begin "Fight" with the body's own tissues - there is an autoimmune process. And the intensity of this process depends on the immune system and body as a whole: the more rapidly the body fights the infection, the more likely the activation of autoimmune processes.
In the first place, the inner heart of the heart is involved in the process, which is involved in the structure of the heart valves - the endocardium, an inflammatory process of endocarditis occurs, while the boar is most often aorized by the aortic valve, and the girls are a mitral valve. At the same time, antibodies that damage the tissues of the joints begin to develop - rheumatic arthritis develops.
In joints there is swelling of cartilaginous tissue, the appearance of intraarticular effusion, leading to persistent edema and limitation of mobility. After removing the exacerbation, stiffness can be maintained, reducing performance. Often, the painful process involves Para-articular tissues surrounding the joint, in the articular bags there are manifestations of bursitis (accumulation of fluid) and sinivitis, although less pronounced than in rheumatoid polyarthritis. Fertility of manifestations of arthritis is largely determined by the activity of autoimmune processes. In older age-related arthritis, always accompanied by severe osteoporosis.
Basic manifestations of rheumatoid arthritis
Manifestations of this disease can be very acute and then speak of acute rheumatic attack, which is accompanied by fever, chills, sweating, weakness, palpitations, joint pain. At the same time, the symptom of "volatile pains" is very characteristic for rheumatism: First, some large joints hurt, then pain in them passes, but others begin to contract, often asymmetrically affects the joints. But in some cases, the symptoms may be slightly expressed and have the appearance of an ordinary cold disease, when just "breaking" the bones and experiencing a general breakdown. If anti-inflammatory therapy is performed, then pain can be stopped in a few hours, but without treatment may disturb the patient for several weeks. Sometimes there are redness areas on the skin (erythema) and small, not very dense subcutaneous rheumatic nodules. Often there is a neurological symptomatology: small twitching of the muscles - hyperkinesis, impaired coordination of movements, and sometimes weakness of the muscular system, which gives a picture of false paralysis.
When rheumatic lesion of joints and heart, valvular vices are often developed, which are manifested by insufficient sealing of the chambers of the heart with each other when it is reduced. As a result of this, the heart chambers are gradually increased due to the additional volume of blood sent to them from neighboring departments. All this leads to the depletion of the contractile capacity of the heart muscle and the development of cardiovascular insufficiency, to disturbances of blood oxygen saturation. In addition to the heart, the target organs in rheumatism are the joints and kidneys, rarer involve other organs and systems.
Diagnosis of rheumatism
Performed by means of laboratory and instrumental research methods: ECG, blood test (acceleration of ESR, the presence of C-reactive protein, increased titres of streptococcal antibodies, etc.), isolation of streptococcus from wheezing with determination of its sensitivity to antibiotics, echocardiography (heart study with Using ultrasound), X-ray examination of the chest and joints (on indications), etc.
Features of treatment for rheumatic arthritis and its prevention
In the timely treatment of a doctor and correctly established diagnosis, it is possible to avoid such complications of streptococcal tonsillitis (in 80% of cases it is after them that such complications occur). Conducting self-treatment with the use of folk remedies in these cases is unacceptable, since it is not able to completely overcome the streptococcal infection. Therefore, many parents, in due time did not apply to the doctor, are guilty of developing a child with rheumatic fever, as at present there are many medicines that allow it to successfully treat this disease and prevent the infection from infecting other organs.
But even with the correct diagnosis and timely treatment, further development of rheumatism is possible. This is due to the fact that patients, having been treated for several days, when the first signs of improving the state of health, cease to accept antibacterial drugs, preferring to no longer "immolate themselves in chemistry". The infection is not destroyed, but only weakened, it continues to develop secretly, and after a month there is already a symptom of the disease of the heart and joints, and treatment with antibiotics at this time is already ineffective.
Depending on the patient's individual health features, periods of exacerbation of rheumatism can last up to several months, but with effective individual selection of drugs, it can reduce the duration and reduce inflammation in the joints, prevent heart and other complications. Therefore, systematic medical control of the patient's health is necessary, as well as preventive measures: increasing resistance to colds, proper nutrition, tempering procedures, sanatorium and spa treatment, etc.
Secondary prophylaxis is also required, which is to use a special protivostreptokokkovyy drug bicillin, which has a long (about a month after the injection) action. An indication for the use of this drug is the presence after a sore throat of a rheumatic attack, which does not immediately end with the formation of heart disease.
There are certain bicillin treatment regimens that are prescribed by a doctor, and this treatment is very long (for several years). If the heart defect has already been formed and the patient has undergone heart surgery (endoprosthetics - replacement of damaged heart valves for new ones - artificial), then injections Bitsillin spend for life under the constant supervision of a doctor.